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  4. Clinical characteristics and molecular mechanisms underlying bladder cancer in individuals with spinal cord injury: a systematic review

Clinical characteristics and molecular mechanisms underlying bladder cancer in individuals with spinal cord injury: a systematic review

BMC Urology, 2024 · DOI: https://doi.org/10.1186/s12894-024-01457-0 · Published: April 1, 2024

Spinal Cord InjuryUrologyOncology

Simple Explanation

This study reviews the clinical characteristics and molecular mechanisms of spinal cord injury patients with bladder cancer. The goal is to help clinicians better recognize and manage these patients. The review of existing research shows that bladder cancer occurs more frequently and is more deadly in spinal cord injury patients compared to the general population. Squamous cell carcinoma is the most common type of bladder cancer in these patients. Long-term catheter use and urinary tract infections contribute to bladder cancer development. Molecules like NO, MiR 1949 and Rb 1 also play a crucial role.

Study Duration
1960 to 2023
Participants
254 articles included after screening
Evidence Level
Systematic Review

Key Findings

  • 1
    The incidence and mortality rates of bladder cancer are higher in spinal cord injury (SCI) patients compared to the general population.
  • 2
    Squamous cell carcinoma (SCC) is the most frequent pathological type of bladder cancer observed in SCI patients.
  • 3
    Molecules such as NO, MiR 1949 and Rb 1 play a crucial role in the pathogenesis of bladder cancer in SCI patients, alongside long-term urinary tract infection and indwelling catheterization.

Research Summary

This systematic review highlights the increased risk of bladder cancer in patients with spinal cord injury (SCI), addressing both clinical characteristics and underlying molecular mechanisms. The review identifies that SCI patients often develop more aggressive forms of bladder cancer at a younger age compared to the general population. The study concludes that further research is needed to expand the understanding of the molecular mechanisms involved in bladder cancer development in SCI patients.

Practical Implications

Enhanced Screening Protocols

Establish and implement specific screening protocols for bladder cancer in SCI patients to improve early detection and treatment outcomes.

Targeted Molecular Research

Further investigate the molecular mechanisms, such as the roles of NO, MiR-1949, and Rb1, to identify potential therapeutic targets for bladder cancer in SCI patients.

Optimized Bladder Management

Promote the use of clean intermittent catheterization (CIC) over long-term indwelling catheters to reduce the risk of urinary tract infections and subsequent bladder cancer development.

Study Limitations

  • 1
    Differences in reporting across included studies.
  • 2
    Inclusion of retrospective studies with potential risk of bias.
  • 3
    Limited number of patients in some studies, affecting generalizability.

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