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Characteristics and clinical significance of histological variants of bladder cancer

机译：膀胱癌组织学变体的特征及临床意义

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摘要

In the past 10 years evidence for the clinical relevance of variant histology in urinary bladder cancer has been increasing. This increase has resulted in new classifications of urothelial cancers by the WHO in 2016, highlighting the importance of an accurate morphological description of pathological specimens for the therapeutic management of patients with bladder cancer. The rising awareness of the importance of an accurate pathological report manifests itself in the increasing prevalence of reporting of variant histology in daily practice. Histological variants can generally be divided into urothelial and nonurothelial. Urothelial variants often have similar features that also have specific morphological phenotypes, whereas nonurothelial variants have independent features. Overall, histological variants follow a more aggressive clinical course than conventional urothelial carcinoma, but conclusive data on their effect on survival are currently lacking. The clinical relevance of variant histology can manifest at three different levels: diagnostic, as identification is challenging and misinterpretation is not uncommon; prognostic, for patient risk stratification and outcome estimation; and therapeutic, as particular variants could be responsive to specific treatment strategies. An accurate morphological description of histological variants is necessary for patient consultation and therapy planning. Moreover, the association of variant histology with specific mutation patterns promises to be helpful in discovering targeted therapeutic approaches based on specific molecular pathways.
机译：在过去的10年里，膀胱癌中变体组织学的临床相关性的证据一直在增加。这一增长导致2016年世卫组织的尿路上癌的新分类，突出了对膀胱癌患者治疗管理的准确形态学描述的重要性。对准确病理报告的重要性的认识意识表现出在日常实践中越来越多的变体组织学报告的患病率。组织学变体通常可以分为尿路上皮和非尿性。尿路上变异通常具有类似的特征，也具有特定的形态表型，而非科学变异具有独立的特征。总体而言，组织学变体遵循比常规尿路上皮癌更具侵略性的临床课程，但目前缺乏关于它们对生存作用的确凿数据。变体组织学的临床相关性在三种不同的水平中表现出：诊断，因为鉴定是挑战性，误解并不少见;预后，用于患者风险分层和结果估计;和治疗剂，特定的变体可能对特定的治疗策略响应。对于患者咨询和治疗计划是必要的组织学变体的准确形态学描述。此外，具有特定突变模式的变体组织学的关联有助于基于特定分子途径发现靶向治疗方法。

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  • 来源
    《Nature reviews. Urology》 |2017年第11期|共18页
  • 作者

    Moschini Marco; DAndrea David; Korn Stephan; Irmak Yasin; Soria Francesco; Comperat Eva; Shariat Shahrokh F.;

  • 作者单位

    Med Univ Vienna Vienna Gen Hosp Dept Urol Comprehens Canc Ctr Wahringer Gurtel 18-20 A-1090;

    Med Univ Vienna Vienna Gen Hosp Dept Urol Comprehens Canc Ctr Wahringer Gurtel 18-20 A-1090;

    Med Univ Vienna Vienna Gen Hosp Dept Urol Comprehens Canc Ctr Wahringer Gurtel 18-20 A-1090;

    Med Univ Vienna Vienna Gen Hosp Dept Urol Comprehens Canc Ctr Wahringer Gurtel 18-20 A-1090;

    Med Univ Vienna Vienna Gen Hosp Dept Urol Comprehens Canc Ctr Wahringer Gurtel 18-20 A-1090;

    UPMC Hop Tenon AP HP Dept Pathol 4 Rue Chine F-75020 Paris France;

    Med Univ Vienna Vienna Gen Hosp Dept Urol Comprehens Canc Ctr Wahringer Gurtel 18-20 A-1090;

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  • 正文语种 eng
  • 中图分类 泌尿科学（泌尿生殖系疾病）;
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