Bladder Cancer refers to any of several types of malignant growths of the urinary bladder. It is a disease in which abnormal cells multiply without control in the bladder. The bladder is a hollow, muscular organ that stores urine; it is located in the pelvis. The most common type of bladder cancer begins in cells lining the inside of the bladder and is called urothelial cell or transitional cell carcinoma (UCC or TCC). Exposure to environmental carcinogens of various types is responsible for the development of most bladder cancers. Tobacco abuse (specifically cigarette smoking) is thought to cause 50% of bladder cancers discovered in male patients and 30% of those found in female patients. Thirty percent of bladder tumors probably result from occupational exposure in the workplace to carcinogens such as benzidine. Approximately 20% of bladder cancers occur in patients without predisposing risk factors. Bladder cancer is not currently believed to be heritable (i.e., does not "run in families" as a consequence of a specific genetic abnormality).
beta-hCG (beta human chorionic gonadotrophin)
for T2-T4 bladder tumours, an elevated 
				pre-treatment level of urinary beta-hCG is a marker of poor 
				prognosis and may prove useful in deciding appropriate therapy.
				
				PMID: 8653319
Measurement of serum and/or urine beta HCG 
				appears to be an efficient diagnostic marker for the presence of 
				distant metastases in bladder carcinoma.
				
				PMID: 2478247
			Beta-2-microglobulin
a 
				differentiation marker in bladder cancer. 
				
				PMID: 3534313
BLCA-1
a urine based marker of bladder cancer which 
				may be useful for the detection of this disease.
				
				PMID: 15947579
BLCA-4
a bladder cancer specific biomarker, is 
				present in urine samples from patients with bladder cancer, but 
				not in samples from healthy individuals.
				
				PMID: 16360453
a bladder cancer marker that is highly 
				specific and occurs early in the development of the disease.
				
				PMID: 14977841
Urinary BLCA-4 determination appears to have 
				high potential as a test for screening and monitoring bladder 
				cancer in the general population and in groups at high risk for 
				the disease, such as those with spinal cord injury.
				
				PMID: 10953114
BTA (Bladder tumor antigen)
in combination with urine cytology is a more 
				useful way for diagnosing TCC of the bladder.
				PMID: 1891992
CA19-9 (Carbohydrate antigen 19-9)
promising for use as a biomarker for the 
				detection and monitoring of low-grade and low-stage bladder 
				cancer, with the proviso that patients to be tested should be 
				free of infection.
				
				PMID: 15764245
c-erbB-2
the use of c-erbB-2 
				gene amplification, together with tumor grade and stage, could 
				provide an accurate basis for determining the prognosis of 
				bladder cancer.
				
				PMID: 10792078
Clusterin
serum and urine clusterin can differ between 
				bladder cancer patients and the control group. Urine clusterin 
				could be the possible laboratory marker of bladder cancer.
				
				PMID: 16830064
CYFRA 21-1
Patients with transitional cell cancer of the 
				bladder with evidence of distant metastases showed a significant 
				increase in serum CYFRA 21-1. During chemotherapy CYFRA 21-1 
				appears to be a potentially sensitive and useful indicator for 
				monitoring treatment response.
				
				PMID: 16217281
Cytokeratin-18 (CK18)
It is clear that serum cytokeratin-18 level 
				increases in patients with bladder cancer. However, it can only 
				be useful as a tumor marker in the diagnosis of T(3) and higher 
				staged tumors. This study indicated that cytokeratin-18 does not 
				have any diagnostic value in lower stage bladder cancers.
				
				PMID: 12135697
			Cytokeratin-20 (CK20
a 
				potential marker for bladder cancer, and is significantly more 
				sensitive than urinary cytology. 
				
				
				PMID: 9817302
DD23
quantification in single cells may be 
				particularly useful in targeting cystoscopic intervention for 
				recurrence monitoring and, because of its high specificity, 
				could be a tool for bladder cancer screening in high-risk 
				groups.
				
				PMID: 8959319
expression can be used as an adjunct to 
				cytopathologic evaluation to enhance the sensitivity of urinary 
				cytology detection of TCC.
				
				PMID: 12639642
EMA (Epithelial membrane antigen)
could be a valuable indicator for 
				histological grading or staging in pathological diagnosis and 
				for predicting the survival of bladder cancer patients.
				
				PMID: 3303592
ERCC1
				a novel 
				prognostic marker in advanced bladder cancer patients receiving 
				cisplatin-based chemotherapy.
				
				PMID: 17229776
F-actin
could be an early and sensitive marker for 
				bladder cancer detection and risk prognostication.
				
				PMID: 2032215
FAS
a 
				promising novel urinary marker for the detection of recurrent 
				superficial bladder cancer. 
				
				PMID: 16541433
FBP (fucose-binding proteins)
degree of expression of FBP binding sites 
				correlates with the increased metastatic potential of bladder 
				cancer and with poor patient survival times.
				
				PMID: 8339222
GNAS1
a novel independent 
				prognostic marker for clinical outcome supporting a functional 
				role of G(alpha)s in bladder cancer progression.
				
				PMID: 15824158
H19
can be used as a tumor marker in human 
				bladder carcinoma, where its expression indicates a more 
				malignant potential.
				
				PMID: 7855987
Hyaluronic acid (HA), a 
				glycosaminoglycan and known to promote tumor cell adhesion and 
				migration, and its small fragments stimulate angiogenesis, is
				a new sensitive 
				and specific urine marker for bladder cancer.
				
				PMID: 9044859
Hyaluronan (HA)
HA in addition to being one of the best 
				markers for the initial evaluation of bladder carcinoma can be 
				used to determine the presence of a residual tumor. This is 
				associated with poor prognosis.
				
				PMID: 16310928
			Hyaluronidase
a 
				diagnostic urine marker for high-grade bladder cancer. 
				
				PMID: 9044860
hTERT
expression in urine sediments represents a 
				reliable tool for the detection of primary urothelial neoplasms, 
				equally specific, yet far more sensitive, than conventional 
				cytology.
				
				PMID: 12893365
Lewis X antigen
Lewis X antigen on 
				exfoliated bladder cells enhances the detection of urothelial 
				tumor cells, particularly from low grade and low stage neoplasms.
				
				
				PMID: 2405185
MMP-2 (matrix metalloproteinase-2)
MMP-2 protein 
				overexpression may be an independent prognostic biomarker for 
				bladder cancer progression. 
				
				PMID: 14624933
Neutral Endopeptidase
will serve as a new tumor marker for bladder 
				cancer as well as acute lymphatic leukemia.
				
				PMID: 7627835
NMP22
			(Nuclear Matrix Protein 22)
				recurrence marker in bladder cancer. 
				
				PMID: 10900760
urinary NMP22 is a 
				useful tool for the screening of urothelial cancer in patients 
				with microscopic hematuria. 
				
				PMID: 9170522,
				
				PMID: 9170521
Urinary NMP22 is a 
				useful diagnostic marker as a substitute for voided-urine 
				cytology for the surveillance of urothelial cancer. 
				
				PMID: 9076459
OCT-4
an 
				embryonic stem cell marker, is highly expressed in bladder 
				cancer. 
				
				PMID: 17205510
p53
can be used as a tumor marker for bladder 
				cancer.
				
				PMID: 15503000
p53 nuclear 
				immunostaining yields clinically relevant information and may be 
				a useful tool for selecting patients with superficial bladder 
				cancer who might be resistant to BCG. 
				
				PMID: 15041112
Prothymosin-alpha
urine prothymosin-alpha has the potential of 
				being a useful tumor marker for the detection and follow-up of 
				bladder cancer.
				
				PMID: 16461079
Survivin
a 
				sensitive marker for the noninvasive diagnosis of bladder 
				cancer. 
				
				PMID: 14713774
T antigen
useful to predict the 
				response of bladder tumors to treatment with bacillus Calmette-Guerin 
				and interleukin-2. 
				
				PMID: 2477561
			Telomerase
an 
				important marker in the diagnosis of bladder cancer. 
				
				PMID: 15153335
the presence of telomerase in bladder washes may be a specific marker of bladder cancer, especially in low-grade tumors. PMID: 9533519
can be determined in voided urine samples of 
				patients with superficial bladder cancer. It has a higher 
				sensitivity and specificity than conventional urinary cytology 
				and is a good marker for diagnosis and follow-up of these 
				patients.
				PMID: 10851728
Thymidine 
			Kinase 1 (TK-1)
a 
				proliferation marker for determining prognosis and monitoring 
				the surgical outcome of primary bladder carcinoma patients.
				
				
				PMID: 16391869
Thymidine 
			Phosphorylase (TP)
a prognostic marker for predicting recurrence in primary superficial bladder cancer. PMID: 16820903
TPA (Tissue polypeptide antigen)
a useful marker not for the early detection 
				of bladder cancer but for the monitoring of the efficacy of a 
				treatment.
				
				PMID: 8694544
Transferrin Receptors (TFR)
TFR activity in low grade superficial bladder 
				tumours is a useful marker for predicting the recurrence rate.
				
				PMID: 2004229
UCA1 (urothelial carcinoma associated 1)
a very sensitive and specific unique marker 
				for bladder cancer.
				
				PMID: 16914571
Uroplakin II (UP II)
might be a more useful 
				marker than CK 20 for detecting micrometastases of bladder 
				cancer in the pelvic lymph nodes, although a greater number of 
				patients and longer followup are needed to come to a definitive 
				conclusion.
				
				PMID: 16280744
XIAP
a prognostic marker of early recurrence of nonmuscular invasive bladder cancer. PMID: 17439739
Other Bladder Cancer Markers
Resting NOR had a predictive value in the 
				prognosis of patients with invasive bladder tumor.
				
				PMID: 11564895
Microvessel density (MVD) in bladder 
				carcinoma correlates with grade, stage and malignant potential 
				of the tumor.
				
				PMID: 15783115
				
				Hydronephrosis is a prognostic marker in bladder cancer in a 
				cystectomy-only series. 
				
				PMID: 16904815
				
noninvasive urinary glycosaminoglycan 
				analysis may well provide a new biochemical approach for 
				detecting and monitoring the pathogeneses of bladder cancer.
				
				PMID: 6793229