What is the most common molecular biologic pathway for urothelial carcinoma (UC) in the bladder?

Updated: Feb 23, 2021
  • Author: Kara N Babaian, MD, FACS; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Answer

The most common molecular biologic pathway for UCs involves the development of a papillary tumor that projects into the bladder lumen and, if untreated, eventually penetrates the basement membrane, invades the lamina propria, and then continues into the bladder muscle, where it can metastasize.

This progression occurs with high-grade cancers only. Low-grade cancers rarely, if ever, progress and are thought to have a distinct molecular pathway, different from the high-grade cancers and CIS.

CIS, which constitutes 10% of UCs, follows a different molecular pathway. This is a flat, noninvasive, high-grade UC that spreads along the surface of the bladder, staying superficial to the basement membrane. Over time, this may progress to an invasive form of cancer that behaves the same as invasive UC.


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