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Utility of Diagnostic and Prognostic Markers in Urothelial Carcinoma of the Bladder

Coleman, Joshua F. MD; Hansel, Donna E. MD, PhD

Advances in Anatomic Pathology: March 2009 - Volume 16 - Issue 2 - pp 67-78
doi: 10.1097/PAP.0b013e318199f89e
Review Articles

Urothelial carcinoma (UCC) of the bladder demonstrates diverse morphologic features, often leading to diagnostic challenges in the discrimination between UCC and benign mimickers of neoplasia, and between primary UCC and secondary neoplasms involving the bladder. In situ lesions also provide diagnostic difficulty in some instances, most prominently in the distinction between normal, reactive urothelium and flat urothelial carcinoma in situ. The use of ancillary techniques, including panels of immunohistochemical markers, in distinguishing these entities has aided not only in the diagnosis of UCC, but has also provided insight into the molecular pathogenesis and prognostic value of numerous molecular pathways in UCC. This review focuses on some of the more commonly encountered biomarkers in UCC and their role in addressing key diagnostic and prognostic issues in this disease process.

Department of Anatomic Pathology, Glickman Urological and Kidney Institute, Taussig Cancer Institute and Genomic Medicine Institute, The Cleveland Clinic, Cleveland, OH

Reprints: Donna E. Hansel, MD, PhD, Department of Anatomic Pathology, Glickman Urological and Kidney Institute, Taussig Cancer Institute and Genomic Medicine Institute, The Cleveland Clinic, 9500 Euclid Avenue, Desk L25, Cleveland, OH 44195 (e-mail: hanseld@ccf.org).

All figures can be viewed online in color at http://www.anatomicpathology.com.

© 2009 Lippincott Williams & Wilkins, Inc.