Molecular subtypes of urothelial carcinomas of the bladder in young patients
Abstract
Urothelial carcinomas in young patients are characterized by specific clinical and morphological and genetic features in contrast to their counterparts in elderly patients. Molecular profiling of tumors in 56 patients under 45 years has been performed using the method of Swedish researchers from the Lund University, the molecular classification of the Lund group of researchers using immunophenotyping has been adapted to the cohort of young patients for the first time and clear reproducibility of urothelial carcinoma molecular subtypes occurring in the elderly group of patients has been demonstrated.
The urothelial-like A subtype of bladder cancer (78%, p = 0.005), which is associated with an early pathological stage, a favorable prognosis, and the best survival rate, was found to significantly predominate in young patients. Within the urothelial-like subtype, a specific tumor variant (so-called CK5/6+/p16+) (7%) was identified, differing in immunophenotypic and clinical features, tending to a more aggressive biological behavior and probably reflecting a different progression pathway of some urothelial carcinomas in contrast to the elderly patients. The frequency of adverse subtypes (urothelial- like B, genomically unstable, basal/squamous cell-like, mesenchymal-like) in the young group was not more than 6%; their occurrence in patients over 30 years of age with an age-proportional dependence was noted.
The performed molecular profiling of bladder cancer in young patients showed its diagnostic significance, possibility of prognostic stratification and, therefore, reasonable practicality.
About the Authors
I. A. Meshcheryakov
St. Petersburg Clinical Scientific and Practical Center of Specialized Types of Medical Care (Oncologic)
Russian Federation
Russian Federation
Meshcheryakov Igor Aleksandrovich — Pathologist
68А, A, Pesochny, Leningradskaya str., St. Petersburg, 197758, Russia
K. A. Kryukov
St. Petersburg Clinical Scientific and Practical Center of Specialized Types of Medical Care (Oncologic)
Russian Federation
Russian Federation
Kryukov Kirill Andreevich — Pathologist
N. P. Mitin
St. Petersburg Clinical Scientific and Practical Center of Specialized Types of Medical Care (Oncologic)
Russian Federation
Russian Federation
Mitin Nikolay Pavlovich — Doctor of Clinical and Laboratory Diagnostics
E. V. Ponomareva
City Clinical Oncological Health Center (St. Petersburg)
Russian Federation
Russian Federation
Ponomareva Elena Vasilyevna — Pathologist
K. V. Shelekhova
St. Petersburg Clinical Scientifi c and Practical Center of Specialized Types of Medical Care (Oncologic); St. Petersburg Medico-Social Institute
Russian Federation
Russian Federation
Shelekhova Kseniya Vladimirovna — Dr. Sci. (Med.), Professor, Head, Pathology Department; Head, Department of Pathological Anatomy
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Review
For citations:
Meshcheryakov I.A., Kryukov K.A., Mitin N.P., Ponomareva E.V., Shelekhova K.V. Molecular subtypes of urothelial carcinomas of the bladder in young patients. Journal of Siberian Medical Sciences. 2021;(3):82-104. (In Russ.)
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