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Harnblasentumoren

Die neue WHO-Klassifikation 2004

Urinary bladder tumours

The new 2004 WHO classification

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Zusammenfassung

Im Bereich der molekulargenetischen Forschung am Harnblasenkarzinom gibt es zunehmend Erkenntnisse, die uns helfen, dass morphologische Bild besser zu verstehen und anders zu klassifizieren. Wegweisend und zielführend wird dieses neue Wissen nur dann sein, wenn es mit dem klinischen Verlauf der Harnblasentumoren und der Histopathologie korreliert werden kann. Die konsequente Verwendung der neuen Klassifikation (WHO-Klassifikation 2004) resultiert in einer einheitlichen Diagnose der Urotheltumoren durch die scharfe Definition der Subgruppierung, sodass in Zukunft weltweit Studien miteinander verglichen und Risikoprofile stratifiziert werden können. Durch weitere Forschung im Bereich der Molekulargenetik und Korrelation mit der aktuellen Klassifikation kann sich durch molekularbiologische Techniken eine Verfeinerung dieses Schemas durch z. B. immunhistochemische Subklassifizierungen ergeben, um potenziell genetisch instabile Tumoren herauszufiltern. Ziel dieser Arbeit ist die Präsentation der neuen WHO-Klassifikation der Harnblasentumoren 2004 mit ihren Änderungen vergleichend zu den vorangegangen Klassifikationen mit dem Fokus auf histologische Typisierung, Grading und molekulare Charakterisierung. Bis zur endgültigen Validierung und bis zum „Erlernen“ der neuen Klassifikation soll weiterhin die WHO-Klassifikation von 1973 im histopathologischen Befund ergänzend erwähnt werden.

Abstract

Increasing knowledge in molecular genetic research on urinary bladder carcinoma has allowed us to classify the morphological picture on the basis of a better understanding. But this new knowledge will only be ground-breaking if it can be correlated with the clinical outcome of urinary bladder tumours and with histopathological findings. The use of the new 2004 WHO classification results in a standardized diagnosis of urothelial tumours by means of an exact definition of the subgroups. In the future, trials can thus be compared worldwide and risk profiles can be stratified. Further research in molecular genetics and correlation with the current classification together with molecular biological techniques may allow refinement of this scheme, e.g. by immunohistochemical subclassifications, enabling identification of potentially genetically unstable tumours. In this paper we present the new 2004 WHO classification of urinary bladder tumours emphasizing the changes in relation to the former classifications focusing on histological typing, grading and molecular characterization. Until the new classification is finally validated, and those working in the field have become familiar with it, the WHO classification of 1973 should be mentioned additionally in the histopathological report.

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Authors and Affiliations

  1. Urologische Klinik und Poliklinik, Klinikum der Universität — Großhadern, Ludwig-Maximilians-Universität, München

    M. Seitz, D. Zaak & C. Stief

  2. Institut für Pathologie, Universitätsklinikum RWTH Aachen

    R. Knüchel-Clarke

  3. Urologische Klinik und Poliklinik, Klinikum der Universität—Großhadern, Ludwig-Maximilians-Universität München, Marchioninistraße 15, 81377, München

    M. Seitz

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  1. M. Seitz
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  2. D. Zaak
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Correspondence to M. Seitz.

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Seitz, M., Zaak, D., Knüchel-Clarke, R. et al. Harnblasentumoren. Urologe 44, 1073–1086 (2005). https://doi.org/10.1007/s00120-005-0901-x

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  • DOI: https://doi.org/10.1007/s00120-005-0901-x

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