Department of Urology, First Affiliated Hospital, Dalian Medical University, Dalian, China.
Department of Pathology and Laboratory Medicine, School of Medicine, Indiana University, Indianapolis, Indiana, USA.
Cancer Sci. 2023 Mar;114(3):984-994. doi: 10.1111/cas.15634. Epub 2022 Nov 30.
Although renal pelvic and ureteral urothelial carcinoma share similarities in their origins, disparities on a genetic and clinical level make them divergent entities. Clinical information from the Surveillance, Epidemiology, and End Results (SEER) database was used to validate the characteristics and molecular subtypes using single-center data, which were compared between the two types of muscle-invasive tumors. Simultaneously, to expand the sample size for further verification, we explored a deep learning algorithm to correctly classify molecular subtypes from H&E histology slides. We suggested that the renal pelvic group might have a proclivity towards luminal and the ureter towards basal and P53-like. Furthermore, we explore the heterogeneity of matrix and immune tumor microenvironment, and the ureteral group had more immune cell infiltration and higher stiffness. Collectively, these results showed that muscle-invasive upper tract urothelial carcinoma exist in distinct properties of clinical characteristics, molecular subtype, and tumor microenvironment.
虽然肾盂和输尿管尿路上皮癌在起源上有相似之处，但在遗传和临床水平上的差异使它们成为不同的实体。我们利用监测、流行病学和最终结果（SEER）数据库中的临床信息，使用单中心数据对特征和分子亚型进行验证，并对两种肌层浸润性肿瘤进行比较。同时，为了进一步验证，我们探索了一种深度学习算法，以正确地从 H&E 组织学切片中分类分子亚型。我们提出，肾盂组可能倾向于腔型，而输尿管组倾向于基底型和 P53 样型。此外，我们还探索了基质和免疫肿瘤微环境的异质性，输尿管组有更多的免疫细胞浸润和更高的硬度。综上所述，这些结果表明，肌层浸润性上尿路上皮癌在临床特征、分子亚型和肿瘤微环境方面存在明显的特性差异。
