Minner S, Sauter G
Institut für Pathologie, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
Pathologe. 2009 Dec;30 Suppl 2:179-84. doi: 10.1007/s00292-009-1192-6.
Principally there are two different types of bladder cancer. Non-invasive papillary low grade tumors (pTa G1-G2) are genetically stable, recur frequently but show a low risk of progression. On the other hand there are high grade tumors (pT1-4, carcinoma in situ), which are genetically unstable, show biologically aggressive behaviour and progress. The distinction between non-invasive (pTa) and minimal-invasive (pT1) is one of the most challenging areas in bladder pathology. Due to the lack of appropriate auxiliary analysis the diagnosis is based entirely on histopathology. P53 immunohistochemistry can be helpful in the assessment of recurring high grade neoplasia. Targeted therapy in bladder cancer is particularly interesting, since a high number of oncogenes are activated and overexpressed (e.g. HER2 and EGFR).
主要有两种不同类型的膀胱癌。非侵袭性乳头状低级别肿瘤(pTa G1-G2)基因稳定,复发频繁,但进展风险低。另一方面,高级别肿瘤(pT1-4,原位癌)基因不稳定,表现出生物学侵袭性行为并会进展。非侵袭性(pTa)和微侵袭性(pT1)之间的区分是膀胱病理学中最具挑战性的领域之一。由于缺乏适当的辅助分析,诊断完全基于组织病理学。P53免疫组化有助于评估复发性高级别肿瘤。膀胱癌的靶向治疗尤其令人关注,因为大量癌基因被激活并过度表达(例如HER2和EGFR)。