Departamento de Cirurgia Pélvica, Serviço de Urologia AC Camargo Cancer Center, São Paulo, Brasil, São Paulo, Brasil.
Departamento de Patologia, AC Camargo Cancer Center, São Paulo, Brasil.
Int Braz J Urol. 2018 Jan-Feb;44(1):22-37. doi: 10.1590/S1677-5538.IBJU.2017.0204.
Upper tract urothelial carcinoma (UTUC) is a rare and aggressive disease that is associated with high rates of recurrence and death. Radical nephroureterectomy (RNU) with excision of the bladder cuff is considered the standard of care for high-risk UTUC, whereas kidney-sparing techniques can be indicated for select patients with low-risk disease. There is a significant lack of clinical and pathological prognostic factors for stratifying patients with regard to making treatment decisions. Incorporation of tissue-based molecular markers into prognostic tools could help accurately stratify patients for clinical decision-making in this heterogeneous disease. Although the number of studies on tissue-based markers in UTUC has risen dramatically in the past several years-many of which are based on single centers and small cohorts, with a low level of evidence-many discrepancies remain between their results. Nevertheless, certain biomarkers are promising tools, necessitating prospective multi-institution studies to validate their function.
上尿路尿路上皮癌（UTUC）是一种罕见且侵袭性强的疾病，其复发和死亡风险较高。根治性肾输尿管切除术（RNU）联合膀胱袖状切除术被认为是高危 UTUC 的标准治疗方法，而对于低危疾病的特定患者，可以采用保留肾脏的技术。目前，在制定治疗决策方面，用于分层患者的临床和病理预后因素明显缺乏。将基于组织的分子标志物纳入预后工具中，可以帮助在这种异质性疾病中准确分层患者以进行临床决策。尽管过去几年中 UTUC 组织标志物的研究数量急剧增加——其中许多研究基于单个中心和小队列，证据水平较低——但它们的结果之间仍然存在许多差异。然而，某些生物标志物是很有前途的工具，需要进行前瞻性多机构研究来验证它们的功能。
