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Präneoplastische Läsionen und Vorstufen des Urothelkarzinoms

Preneoplastic lesions and precursors of urothelial cancer

  • Schwerpunkt: Uropathologie
  • Published:
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Zusammenfassung

Nachdem schon eine einfache Verdickung des Urothels genetische Veränderungen zeigen kann, die denen papillärer differenzierter Urothelkarzinome entsprechen, ist es nicht leicht, präkanzeröse Urothelveränderungen rein morphologisch eindeutig zu erkennen. Immunhistochemische und molekulare Zusatzmethoden unterstützen das differenzierte Erkennen und helfen insbesondere, die klinisch wichtige, genetisch instabile Zelle als Merkmal des Carcinoma in situ (CIS) zu diagnostizieren. Die klinische Bedeutung der vielfältigen morphologischen Erscheinungsformen, die vom großzelligen bis mikropapillären CIS reichen, ist bislang wenig untersucht. Wichtig, nicht zuletzt im Hinblick auf ein besseres Verständnis der möglichen Sonderformen des Harnblasenkarzinoms (Adeno- und Plattenepithelkarzinome), scheint es zudem, die nicht-urothelialen Veränderungen des Urothels wie die intestinale Metaplasie und Plattenepithelmetaplasie hinsichtlich der phänotypischen und molekularen Eigenschaften besser zu definieren.

Abstract

As even a mere thickening of the urothelium can harbor genetic changes identical to that of low grade papillary urothelial tumors, it is not always possible to clearly recognize a precursor lesion of urothelial carcinoma by routine histological diagnostics. Complementary immunohistochemical and molecular diagnostic methods assist the recognition of these entities. These methods especially help to identify clinically important genetically unstable cells as the hallmark of carcinoma in situ (CIS). Little is known about the clinical significance of the morphological subtypes of CIS, which range from large cell to micropapillary variants. For a better understanding of special types of bladder cancer (e.g. adenocarcinoma and squamous cell carcinoma), it seems to be important to define the phenotype and the molecular pattern of non-urothelial lesions, such as intestinal metaplasia and squamous metaplasia, better and more precisely.

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Authors and Affiliations

  1. Institut für Pathologie, Uniklinik RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Deutschland

    R. Knüchel-Clarke & N.T. Gaisa

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  1. R. Knüchel-Clarke
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Correspondence to R. Knüchel-Clarke.

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N.T. Gaisa und R. Knüchel-Clarke geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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A. Hartmann, Erlangen

R. Knüchel-Clarke, Aachen

G. Kristiansen, Bonn

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Knüchel-Clarke, R., Gaisa, N. Präneoplastische Läsionen und Vorstufen des Urothelkarzinoms. Pathologe 37, 33–39 (2016). https://doi.org/10.1007/s00292-015-0130-z

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