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首页> 外文期刊>Modern Pathology >Upper Tract Urothelial Carcinoma: A Clinicopathologic Study Including Microsatellite Instability Analysis
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Upper Tract Urothelial Carcinoma: A Clinicopathologic Study Including Microsatellite Instability Analysis

机译：上道尿道上皮癌：包括微卫星不稳定性分析的临床病理研究。

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Urothelial carcinoma of the renal pelvis and ureter may develop as a manifestation of the hereditary nonpolyposis colorectal cancer syndrome that is characterized by mutations in a number of DNA mismatch repair genes and detectable as microsatellite instability. In this study, we examined microsatellite instability and the clinicopathologic features of urothelial carcinoma of the renal pelvis (n = 61) and ureter (n = 53) from 114 consecutive patients surgically treated from 1985–1992. Clinical data were obtained through chart review. Matched normal and tumor DNA was extracted from paraffin-embedded tissue, and a panel of six microsatellite loci was analyzed. The male-female ratio was 2.8:1 with a median age of 70 years (range, 28 to 92 y). Microsatellite analysis was successful in 67 tumors, and 21 (31.3%) patients had tumors that exhibited microsatellite instability. Patients with microsatellite-unstable tumors were significantly more likely to have additional nonurologic cancers (P = .015) including colorectal carcinoma (P = .001) compared with patients with tumors that did not exhibit microsatellite instability. In addition, patients with microsatellite-unstable tumors showed more colorectal cancers in their family (P = .026) and were more likely to have higher grade urothelial carcinoma of the upper tract (P = .028). Grade and stage, but not microsatellite status, were the strongest predictors of cancer-specific survival. This study found the highest frequency of microsatellite instability in upper urothelial tract carcinomas reported to date and highlights upper tract urothelial carcinoma as a marker of the hereditary nonpolyposis colorectal cancer syndrome in some patients. These findings reinforce the importance of obtaining cancer histories in patients with upper tract urothelial carcinoma to subsequently identify individuals with the hereditary nonpolyposis colorectal cancer syndrome and at-risk relatives for surveillance and management programs.
机译：肾盂和输尿管的尿道上皮癌可能发展为遗传性非息肉病结直肠癌综合症的一种表现，其特征是许多DNA错配修复基因发生突变，可检测为微卫星不稳定性。在这项研究中，我们检查了1985年至1992年连续接受手术治疗的114例患者的微卫星不稳定性以及肾盂（n = 61）和输尿管（n = 53）尿路上皮癌的临床病理特征。通过图表审查获得临床数据。从石蜡包埋的组织中提取匹配的正常DNA和肿瘤DNA，并分析一组六个微卫星基因座。男女比例为2.8：1，中位年龄为70岁（28至92岁）。微卫星分析成功治疗了67个肿瘤，其中21例（31.3％）的患者表现出微卫星不稳定。与未表现出微卫星不稳定的肿瘤患者相比，患有微卫星不稳定的肿瘤患者更有可能患有其他非泌尿外科肿瘤（P = .015），包括结直肠癌（P = .001）。此外，患有微卫星不稳定肿瘤的患者在其家庭中显示出更多的大肠癌（P = .026），并且更有可能患有较高级别的上尿路上皮癌（P = .028）。等级和阶段而不是微卫星状态是癌症特异性生存的最强预测指标。这项研究发现迄今为止报道的上尿路上皮癌中微卫星不稳定性的发生率最高，并强调了上尿路上皮癌是某些患者遗传性非息肉病性结直肠癌综合征的标志。这些发现加强了在上尿路尿路上皮癌患者中获得癌症病史的重要性，以便随后确定患有遗传性非息肉病性结肠直肠癌综合症的个体以及有风险的亲属以进行监测和管理计划。

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