[Cancer of the urinary bladder: current concepts and future]

Recent research trends on carcinoma of the bladder with special references to the current concepts of its pathogenesis, the basic problems on its diagnosis and treatment were reviewed and discussed. 1) The transitional epithelium as the origin of transitional cell carcinoma (TCC) is understandable as an intermediate of squamous and glandular epithelium and the biology on the basal cells is seemed to be the most interesting. 2) Multistage carcinogenesis theory is adapted in the carcinoma of the urinary bladder and the research will be directed to clarify mechanisms to maintain the dormant cell in the state and to develop new technology for quantitative analysis of its promoters and antipromoters. 3) Grading of TCC by the conventional histology is not adequate in the future that new objective criteria to evaluate the structural atypia is expected other than the current DNA analysis by flow cytometry. 4) Endoscopy for diagnosis of the bladder carcinoma should be available to observe whole urinary system and the recorded images should be analyzed by the objective method developed by new technology. 5) New direction of the treatment of the bladder carcinoma will be headed to find a BRM as an antipromoters in the short range strategy.