Lange Fabienne, Hartmann Arndt, Eckstein Markus
Institut für Pathologie, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Krankenhausstraße 8-10, 91054, Erlangen, Deutschland.
Comprehensive Cancer Center EMN, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Deutschland.
Pathologie (Heidelb). 2025 Feb;46(1):21-26. doi: 10.1007/s00292-024-01385-8. Epub 2024 Nov 12.
In recent years, our understanding of the genesis and development of urothelial carcinomas (UC) has expanded considerably thanks to advancing molecular classifications. These advances have led to significant changes in the 5th edition of the WHO classification of tumors of the urinary tract and male genitalia. The new findings allow both the introduction of modern diagnostic approaches and a return to proven methods in the evaluation of precursor lesions and non-invasive carcinomas.
This article is intended to provide a summarized overview of the various precursor lesions and pathways of urothelial carcinoma.
The changes and clarifications in the 5th edition of the WHO classification reflect the progress made in the molecular and morphological characterization of urothelial carcinomas. These adjustments provide an improved basis for diagnosis and treatment and emphasize the importance of differentiated molecular profiles for the classification and treatment of UC. Despite all this, conventional histology remains the gold standard for the diagnosis and classification of non-invasive carcinomas and precursor lesions.
近年来，由于分子分类学的不断发展，我们对尿路上皮癌（UC）的发生和发展的认识有了显著扩展。这些进展导致了《世界卫生组织泌尿系统和男性生殖器官肿瘤分类》第5版的重大变化。新发现既有助于引入现代诊断方法，也有助于在评估前驱病变和非浸润性癌时回归到已证实的方法。
本文旨在对尿路上皮癌的各种前驱病变和途径进行简要概述。
《世界卫生组织分类》第5版中的变化和澄清反映了尿路上皮癌在分子和形态学特征方面取得的进展。这些调整为诊断和治疗提供了更好的基础，并强调了不同分子谱在UC分类和治疗中的重要性。尽管如此，传统组织学仍然是非浸润性癌和前驱病变诊断及分类的金标准。
