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首页> 外文期刊>Nature reviews. Urology >The prognostic role of lymphovascular invasion in urothelial carcinoma of the bladder
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The prognostic role of lymphovascular invasion in urothelial carcinoma of the bladder

机译：淋巴管浸润在膀胱尿路上皮癌中的预后作用

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Outcome prediction in patients with bladder cancer has improved through the development of nomograms and predictive models. However, integration of further characteristics such as lymphovascular invasion (LVI) might increase the accuracy and clinical utility of these instruments. Assessment and reporting of LVI in specimens from transurethral resection of the bladder tumour (TURBT) or biopsy in patients with non-muscle-invasive bladder cancer (NMIBC) or muscle-invasive bladder cancer (MIBC) might enable improved staging, prognostication and clinical decision-making. In NMIBC, presence of LVI in TURBT and biopsy samples seems to be associated with understaging and increased risks of disease recurrence and progression. In MIBC, presence of LVI is associated with features of aggressive disease and predicts recurrence and survival. Integration of LVI status into predictive models might aid clinical decision-making regarding intravesical instillation schedules and regimens, early radical cystectomy in patients with high-grade T1 disease and perioperative chemotherapy. However, LVI assessment is hampered by insufficient reproducibility and reliability, lack of routine evaluation and limited concordance between findings in TURBT and radical cystectomy specimens. Standardization of the pathological criteria defining LVI is warranted to improve its reporting in routine clinical practice and its utility as a care-changing prognostic marker.
机译：膀胱癌患者的结局预测通过列线图和预测模型的开发得到了改善。但是，进一步特征的整合，例如淋巴管浸润（LVI）可能会提高这些仪器的准确性和临床实用性。经尿道膀胱电切术（TURBT）或非肌肉浸润性膀胱癌（NMIBC）或肌肉浸润性膀胱癌（MIBC）患者的活检标本中的LVI评估和报告可能有助于改善分期，预后和临床决策-制造。在NMIBC中，TURBT和活检样本中存在LVI似乎与疾病的分期不足和疾病复发和进展的风险增加有关。在MIBC中，LVI的存在与侵袭性疾病的特征有关，并可以预测复发和生存。将LVI状态整合到预测模型中可能有助于有关膀胱内滴注时间表和治疗方案，高度T1病患者的早期根治性膀胱切除术以及围手术期化疗的临床决策。但是，LVI评估受到重现性和可靠性不足，缺乏常规评估以及TURBT和根治性膀胱切除术标本之间的一致性有限的困扰。定义LVI的病理学标准的标准化可以改善其在常规临床实践中的报告，并可以改善其作为改变预后的指标。

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