Zusammenfassung
Die Harnblasenkarzinome umfassen eine heterogene Gruppe von Erkrankungen mit sehr unterschiedlichem klinischen Ausgang: 70–80% der Harnblasenkarzinome sind genetisch stabil und haben eine günstige Prognose, 20–30% sind genetisch instabil und werden schnell muskelinvasiv. Diese Beobachtungen liegen der aktuellen WHO-Klassifikation von 2004 zugrunde, nach der die malignen Neoplasien nur noch in „low grade“ und „high grade“ differenziert werden. Neben der TNM-Klassifikation und dem Grading haben auch Mutationen von Genen wie p53, Fibroblasten-Wachstumsfaktor-Rezeptor 3 (FGFR3) und Phosphatidylinositol-3-Kinase (PIK 3 CA) eine prognostische Relevanz.
Abstract
Urothelial carcinoma comprise a heterogenous group of diseases with very different clinical outcome: 70%–80% of urothelial carcinoma are genetically stable and associated with a favorable prognosis, while 20%–30% are genetically unstable and have a high progression rate. Therefore, the current WHO Classification (2004) reduces the histologic grade to simply ‘low grade’ and ‘high grade’. In addition to TNM classification and histologic grade, genetic factors such as p53 mutations, fibroblast growth factor receptor 3 (FGFR3) and phosphatidylinositol-3-kinase (PIC 3 CA) are relevant in a patient’s prognosis.
Literatur
Eble JN, Sauter G, Epstsein JI, Sesterhenn IA (eds) (2004) Tumors of the urinary system and male genital tract. WHO Classification of Tumours. Pathology & Genetics. IARC Press, Lyon
Epstein JI, Amin MB, Reuter VE (eds) (2004) Bladder biopsy interpretation. Lippincott Williams & Wilkins, Philadelphia
Grignon DJ (1997) Neoplasms of the urinary bladder. In: Bostwick DG, Eble JE (eds) Urological surgical pathology. Mosby-Year Book, St. Louis, pp 214–305
Hafner C, Knuechel R, Stoehr R, Hartmann A (2002) Clonality of multifocal urothelial carcinomas: 10 years of mulecular genetic studies. Int J Cancer 101: 1–6
Hafner C, Knuechel R, Zanardo L et al. (2001) Evidence for oligoclonality and tumor spread by intraluminal seeding in multifocal urothelial carcinomas of the upper and lower urinary tract. Oncogene 20: 4910–4915
Hungerhuber E, Stepp H, Kriegmair M et al. (2007) Seven years‘ experience with 5-aminolevulinic acid in detection of transitional cell carcinoma of the bladder. Urology 69: 260–264
Jones TD, Cheng L (2006) Papillary urothelial neoplasm of low malignant potential: evolving terminology and concepts. J Urol 175: 1995–2003
Leissner J, Hohenfellner R, Thüroff JW, Wofl HK (2000) Lymphadenectomy in patients with transitional cell carcinoma of the urinary bladder; significance for staging and prognosis. Br J Urol 85: 817–823
López-Knowles E, Hernández S, Malats N et al. (2006) PIK3CA mutations are an early genetic alteration associated with FGFR3 mutations in superficial papillary bladder tumors. Cancer Res 66: 7401–7404
Mitra AP, Datar RH, Cote RJ (2006) Molecular pathways in invasive bladder cancer: new insights into mechanisms, progression, and target identification. J Clin Oncol 24: 5552–5564
Obermann EC, Junker K, Stoehr R et al. (2003) Frequent genetic alterations in flat urothelial hyperplasia and concomitant papillary bladder cancer as detected by CGH, LOH, and FISH analyses. J Pathol 199: 50–57
Stoehr R, Hartmann A (2007) Histopathologie und Molekulargenetik des Harnblasenkarzinoms. Onkologe 12: 1058–1066
Stoehr R, Knuechel R, Boecker J et al. (2002) Histologic-genetic mapping by allele-specific PCR reveals intraurothelial spread of p53 mutant tumor clones. Lab Invest 82: 1553–1561
Lindemann-Docter K, Knüchel-Clarke R (2008) Histopathologie des Harnblasenkarzinoms. Entscheidend für das Management der betroffenen Patienten. Urologe 47: 627–638
Interessenkonflikt
Die korrespondierende Autorin gibt an, dass kein Interessenkonflikt besteht.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Lindemann-Docter, K., Knüchel, R. Aktuelles zur Histopathologie des Harnblasenkarzinoms. Pathologe 29, 331–338 (2008). https://doi.org/10.1007/s00292-008-1012-4
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00292-008-1012-4