Kang Ho Won, Kim Wun-Jae, Yun Seok Joong
Department of Urology, School of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, South Korea.
Department of Urology, Chungbuk National University Hospital, Cheongju, South Korea.
Transl Cancer Res. 2020 Oct;9(10):6609-6623. doi: 10.21037/tcr-20-1243.
Urothelial cell carcinoma (UCC) of the bladder and upper urinary tract is a heterogeneous disease with distinct biologic features resulting in different clinical behaviors. Bladder cancer (BC) is classified into non-muscle invasive BC (NMIBC) and muscle invasive BC (MIBC). NMIBC is associated with high recurrence rates and risk of progression to invasive disease, whereas MIBC is complicated by systemic recurrence after radical cystectomy because of the limited efficacy of available therapies. UCC of the upper urinary tract (UUT-UCC) is a rare but aggressive urologic cancer characterized by multifocality, local recurrence, and metastasis. Conventional histopathologic evaluation of UCC, including tumor stage and grade, cannot accurately predict the behavior of BC and UUT-UCC. Recent clinical and preclinical studies aimed at understanding the molecular landscape of UCC have provided insight into molecular subtyping, inter- or intratumoral heterogeneity, and potential therapeutic targets. Combined analysis of molecular markers and standard pathological features may improve risk stratification and help monitor tumor progression and treatment response, ultimately improving patient outcomes. This review discusses prognostic and therapeutic biomarkers for BC and UUT-UCC, and describes recent advances in molecular stratification that may guide prognosis, patient stratification, and treatment selection.
膀胱和上尿路尿路上皮癌（UCC）是一种异质性疾病，具有独特的生物学特征，导致不同的临床行为。膀胱癌（BC）分为非肌层浸润性膀胱癌（NMIBC）和肌层浸润性膀胱癌（MIBC）。NMIBC与高复发率和进展为浸润性疾病的风险相关，而MIBC由于现有治疗方法疗效有限，在根治性膀胱切除术后会出现全身复发。上尿路尿路上皮癌（UUT-UCC）是一种罕见但侵袭性的泌尿系统癌症，其特征为多灶性、局部复发和转移。UCC的传统组织病理学评估，包括肿瘤分期和分级，无法准确预测BC和UUT-UCC的行为。最近旨在了解UCC分子格局的临床和临床前研究，为分子亚型分类、肿瘤间或肿瘤内异质性以及潜在治疗靶点提供了见解。分子标志物与标准病理特征的联合分析可能会改善风险分层，并有助于监测肿瘤进展和治疗反应，最终改善患者预后。本综述讨论了BC和UUT-UCC的预后和治疗生物标志物，并描述了分子分层方面的最新进展，这些进展可能会指导预后、患者分层和治疗选择。
