Lasermicrodissection - An important prerequisite for the molecular-genetic analysis of bladder cancer

The past 10 years have shown that a crucial point in the molecular-genetic analysis of malignant tumors is the exact histopathological definition and separation of the investigated lesions. Laser microdissection has become an important tool allowing for the study of specific histological entities and defined preneoplastic lesions. Reliable detection of tumor-specific alterations can be compromised by the presence of normal cells. This requires microdissection of pure tumor cell populations (>80%), necessary for detecting chromosomal alterations by loss of heterozygosity analysis (LOH) and fluorescence in situ hybridization (FISH). The combination of microdissection and molecular methods could also be useful for studying multifocal lesions of the urothelial tract. This article describes in detail the use of laser microdissection, whole genome amplification by Improved Primer Extension Preamplification (I-PEP)-PCR and subsequent LOH, FISH, and sequencing analyses for the investigation of urothelial tumors and their precursors, e.g. dysplasias and hyperplasias. The combination of the described methods allows for a wide spectrum of molecular investigations in lesions with a limited number of tumor cells, and might help to understand the fundamental alterations involved in urothelial carcinogenesis.