Tímár József
2. Sz. Patológiai Intézet, Semmelweis Egyetem, Klinikai Központ, Budapest, Hungary.
Magy Onkol. 2014 Sep;58(3):157-60. Epub 2014 Aug 2.
The molecular genetic dogma is valid that the histological variants of a given cancer represent genetic variants. Basis of this subclassification is known in clear cell renal cancer but still a mistery in prostate or bladder cancers. Meanwhile another genetic dogma developed recently that a given histological variant of a cancer can further be subdivided based on molecular characteristics. Best examples are clear cell renal cancer, adenocarcinoma of the prostate or transitional cell carcinoma of the bladder. This new knowledge helps in the differential diagnostics of cancer, and in determining prognosis, but also provides an opportunity to better tailor existing therapies even to consider novel target agents. Discovery of the molecular subtypes of cancers (such as leukemia or lung adenocarcinoma) contributed significantly to the extension of the progression-free or overall survival of cancer patients, and it is expected that it could lead to similar effects in case of urogenital cancers.
分子遗传学的教条是成立的,即特定癌症的组织学变体代表基因变体。这种亚分类的基础在透明细胞肾癌中是已知的,但在前列腺癌或膀胱癌中仍然是个谜。与此同时,最近又形成了另一个基因教条,即癌症的特定组织学变体可以根据分子特征进一步细分。最佳例子是透明细胞肾癌、前列腺腺癌或膀胱移行细胞癌。这一新知识有助于癌症的鉴别诊断、确定预后,也为更好地调整现有治疗方案甚至考虑新型靶向药物提供了机会。癌症分子亚型(如白血病或肺腺癌)的发现显著延长了癌症患者的无进展生存期或总生存期,预计在泌尿生殖系统癌症中也会产生类似效果。