Clinical and therapeutic implications of sex steroid hormone receptor status in urothelial bladder cancer.
Clinical and therapeutic implications of sex steroid hormone receptor status in urothelial bladder cancer.
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DOI：
10.4103/iju.iju_320_19
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发表时间：
2020-07
期刊：
影响因子：
--
通讯作者：
Venugopal P
中科院分区：
文献类型：
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作者：
Moorthy HK;Prabhu GGL;Venugopal P
对膀胱尿路上皮癌（UBC）临床特征的研究显示出显着的性别差异，即男性发病率较高（男女比例为3.5:1），诊断时已处于疾病晚期，初次诊断后疾病进展迅速，女性更常见。性别与 UBC 之间的关系很复杂，并且可能受到生物学和流行病学因素的影响。性类固醇激素途径、环境致癌物暴露的性别差异、代谢酶活性以及诊断评估强度的差异等潜在影响因素可能可以解释 UBC 的人口趋势。这篇对 2009-2019 年 Medline 出版物的综合综述试图确定性激素受体在 UBC 发生和进展中的性别变异和性二态性中可能发挥的作用。鉴定性类固醇受体对疾病预测等因素的临床意义以及抗雄激素在 UBC 预防和进展中的治疗作用进行了严格的审查。目前文献中有大量证据表明性类固醇激素受体介导的信号在 UBC 的发生和进展中可能发挥作用。这些受体包括雄激素受体、雌激素受体、孕激素受体和各种其他孤儿受体。这些受体的表达过度或减少，以及其上游或下游途径的改变，与 UBC 的临床和治疗结果密切相关。
Studies on the clinical profile of urothelial bladder cancer (UBC) have shown significant gender differences, namely, higher occurrence in males (male-to-female ratio of 3.5:1) and an advanced stage of disease at the time of diagnosis with rapid progression of the disease after initial diagnosis seen more commonly in females. The relationship between gender and UBC is complex and probably influenced by biological and epidemiological factors. Potential contributory factors such as sex steroid hormone pathway, gender difference in environmental carcinogen exposure, metabolic enzyme activity, and disparities in the intensity of diagnostic evaluation could probably explain the demographic trends in UBC. This comprehensive review of Medline publications during the period 2009–2019 attempts to identify the possible role of sex hormone receptors in gender variation and sexual dimorphism in the occurrence and progression of UBC. The clinical implications of identifying sex steroid receptors on factors such as disease prognostication and the therapeutic role of anti-androgens in the prevention and progression of UBC are critically reviewed. There is now significant evidence in literature to suggest the possible role of sex steroid hormone receptor-mediated signals in the genesis and progression of UBC. These receptors include androgen receptors, estrogen receptors, progesterone receptors, and various other orphan receptors. Excessive or reduced expression of these receptors, as well as alterations in their upstream or downstream pathways, correlate well with the clinical and therapeutic outcomes of UBC.