Junker K
Klinik für Urologie und Kinderurologie, Universitätsklinikum des Saarlandes.
Aktuelle Urol. 2014 Sep;45(5):370-3. doi: 10.1055/s-0034-1389946. Epub 2014 Sep 17.
Histologically defined subtypes of renal cell tumors (clear cell, papillary, chromophobe, oncocytoma) have to be accepted as distinct tumor entities based on specific and distinct molecular alterations and different prognosis. Immunochemistry and genetic analysis can be used for diagnosis in uncertain cases and are more and more important for individual therapy selection. Differentiation of prognosis in each subtype seems possible by using molecular signatures of primary tumors allowing individual assessment of aggressiveness and metastatic potential. Molecular markers from blood as well as from tumor tissues can predict therapy response in the future. In order to transfer these promising data into clinical practice it is mandatory to develop validation studies which have to be performed based on defined criteria similar to those for therapeutic clinical trials.
肾细胞肿瘤的组织学定义亚型(透明细胞型、乳头状型、嫌色细胞型、嗜酸细胞瘤)必须被视为基于特定且不同的分子改变及不同预后的独特肿瘤实体。免疫化学和基因分析可用于不确定病例的诊断,且对个体化治疗选择越来越重要。通过使用原发肿瘤的分子特征,似乎有可能区分每种亚型的预后,从而对侵袭性和转移潜能进行个体化评估。来自血液以及肿瘤组织的分子标志物未来能够预测治疗反应。为了将这些有前景的数据转化为临床实践,必须开展验证研究,且这些研究必须基于与治疗性临床试验类似的既定标准来进行。