高级尿路上皮癌：放射学最新进展。

Advanced urothelial cancer: a radiology update.

机构信息

Department of Imaging, Dana Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA, 02215, USA.

Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.

出版信息

Abdom Radiol (NY). 2019 Dec;44(12):3858-3873. doi: 10.1007/s00261-019-02148-3.

DOI:10.1007/s00261-019-02148-3

PMID:31363813

Abstract

The recent genomic characterization of urothelial carcinoma by the Cancer Genome Atlas Project, made possible by the introduction of high throughput, reduced cost, and sequence analysis, has shed new insights on the biology of advanced disease. In addition, studies on imaging of advanced urothelial carcinoma have widened the knowledge on disease presentation and on pattern of metastatic spread and their correlation with the underlying biology of urothelial carcinoma. The wide range of treatments for advanced urothelial cancer, including combined chemotherapy regimens and immune checkpoint inhibitors, each result in treatment class-specific patterns of response and adverse events. Results of studies point to the need for a reliable biomarker, perhaps with imaging, that predicts prognosis and treatment response to systemic treatment, and can be used to select the most effective treatment while minimizing toxicity. This review of advanced urothelial cancer introduces the latest advances in genetic profiling, the current role of imaging, the radiographic appearance of treatment response and their toxicities, and details potential future areas of imaging research.

摘要

近年来，癌症基因组图谱计划通过引入高通量、降低成本和序列分析，对尿路上皮癌的基因组特征进行了深入研究，为晚期疾病的生物学研究提供了新的见解。此外，对晚期尿路上皮癌的影像学研究拓宽了人们对疾病表现、转移扩散模式及其与尿路上皮癌基础生物学之间的相关性的认识。晚期尿路上皮癌的治疗方法多种多样，包括联合化疗方案和免疫检查点抑制剂，每种方法都有其特定的治疗反应和不良反应模式。研究结果表明，需要一种可靠的生物标志物，也许可以通过影像学来预测对全身治疗的预后和治疗反应，并用于选择最有效的治疗方法，同时最大限度地降低毒性。本文综述了晚期尿路上皮癌的最新遗传学研究进展、影像学的当前作用、治疗反应的影像学表现及其毒性，并详细介绍了未来影像学研究的潜在领域。