Advance of molecular classification to guide the treatment of muscular invasive bladder cancer
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摘要: 膀胱癌是全球第十大最常见的肿瘤,大概四分之一的患者初诊即被确诊为肌层浸润性膀胱癌(muscular invasive bladder cancer,MIBC),其恶性程度较高,且易发生转移。根据指南,目前根治性膀胱切除术(radical cystectomy,RC)是MIBC的一线治疗方案。但随着治疗水平的进步,有研究证实保留膀胱的三联疗法、新辅助化疗、免疫治疗以及靶向治疗可以改善部分MIBC患者的预后,但目前仍缺乏有效的手段筛选出这部分患者。随着分子生物学技术的发展,多个研究中心将MIBC分为不同的分子亚型,并针对各亚型的临床病理特点进行研究,发现不同亚型MIBC对现有各治疗手段的敏感性存在很大差异。这或许可以为治疗策略的选择提供参考,推动个性化治疗的发展。本文就分子分型指导肌层浸润型膀胱癌治疗的研究进展进行综述。Abstract: Bladder cancer is the tenth most common tumor in the world. About a quarter of patients are diagnosed with muscular invasive bladder cancer(MIBC), which is highly malignant and prone to metastasis. According to the guidelines, radical cystectomy(RC) is currently the first-line treatment for MIBC. However, studies have confirmed that trimodal therapy with bladder preservation, neoadjuvant chemotherapy, immunotherapy, and targeted therapy can improve the prognosis of some MIBC patients, but there is no effective means to screen out these patients. With the development of molecular biology technology, many research centers have divided MIBC into different molecular subtypes, and conducted research on the clinicopathological characteristics of each subtype. The study found that the sensitivity of different subtypes of MIBC to existing treatments is very different. This may provide a reference for the selection of treatment strategies and promote the development of personalized treatment. This article reviews the progress of molecular classification to guide the treatment of MIBC.
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Key words:
- bladder cancer /
- molecular subtype /
- prognosis
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