Department of Pathology, Yale University School of Medicine, New Haven, CT, USA.
Curr Oncol Rep. 2022 May;24(5):603-610. doi: 10.1007/s11912-022-01219-x. Epub 2022 Feb 24.
This review will discuss micropapillary urothelial carcinoma with respect to biology, histopathologic characteristics, genetic and molecular features, diagnosis, clinical management, and future directions of research.
Recent consensus opinion study showed only moderate interobserver reproducibility in the diagnostic criteria. The most reproducible criteria with the highest consensus were multiple nests in the same lacunar spaces. There are recent reports of high rates of intratumoral heterogeneity of ERBB2 amplification within tumor containing both micropapillary and classic urothelial components. Micropapillary urothelial carcinoma is a well-documented highly aggressive variant of urothelial carcinoma with proven worse outcomes. Accurate recognition and reporting of this pattern is critical for optimal management. Newer therapeutic strategies related to the molecular and genetic findings seen in MPUC remain to be explored further.
本文将讨论微乳头尿路上皮癌的生物学、组织病理学特征、遗传和分子特征、诊断、临床管理以及研究的未来方向。
最近的共识意见研究表明，在诊断标准方面只有中等程度的观察者间可重复性。最具可重复性和最高共识的标准是在同一腔隙中有多个巢。最近有报道称，在包含微乳头和经典尿路上皮成分的肿瘤中，ERBB2 扩增的肿瘤内异质性发生率很高。微乳头尿路上皮癌是一种已被充分证实具有高度侵袭性的尿路上皮癌变体，其预后较差。准确识别和报告这种模式对于最佳管理至关重要。与 MPUC 中观察到的分子和遗传发现相关的新治疗策略仍有待进一步探索。
