肉瘤样尿路上皮癌的临床特点及分子病理学特征

目的探讨肉瘤样尿路上皮癌(sarcomatoid urothelial carcinoma,SUC)的临床特点及分子病理学特征。方法回顾性分析20例SUC的临床病理学特征,其中6例采用荧光原位杂交(flourescence in situ hybridization,FISH)技术检测患者尿脱落细胞,分析其分子病理学特征。结果20例SUC患者中,男性17例,女性3例;发病年龄46~70岁,中位年龄58岁。肿瘤部位:13例位于膀胱、5例位于肾盂、2例位于输尿管。肿瘤侵犯全层12例,浸润深肌层6例,浅肌层2例。18例患者获得随访,随访时间5~17个月,其中15例死亡,3例存活。6例患者行尿脱落细胞FISH检测,4例发现3或7号染色体的多倍体。结论SUC属于高度侵袭且预后差的肿瘤,好发于老年男性,主要发生于膀胱,确诊需依据其病理形态学特征及免疫组化检测。FISH技术检测患者尿路脱落细胞,是诊断SUC的无创性辅助检查方法。

Clinicopathological and molecular pathological analysis of sarcomatoid urothelial carcinoma

Purpose To examine the clinicopathological and moleculaRpathological features of sarcomatoid urothelial carcinoma(SUC).Methods To reviewed the clinicopathological data of 20 patients with SUC.Fluorescence in situ hybridization(FISH)technology was used to detect the urine cytology of 6 patients,and analysed its moleculaRpathological characteristics.Results Among 20 patients with SUC,17 were male and 3 were female.The age of onset with these patients was 46-70 years old,and the median age was 58 years old.13 cases were located in the bladder,5 cases were located in the renal pelvis,and 2 cases were located in the ureter.Tumors invaded the whole layeRin 12 cases,deep musculaRlayeRin 6 cases and superficial musculaRlayeRin 2 cases.The patient’s postoperative time was 5-17 months,and the median survival time was only 8 months.FISH detection was performed in the urine exfoliated cells of 6 patients,polyploidy of chromosome 3 oR7 was found in 4 patients.Conclusion The SUC is frequently found in elderly male patients.The location of the disease is mainly located in the bladder.SUC is a highly aggressive and poorly differentiated tumor.The diagnosis needs to be based on its histopathological features and immunohistochemical staining.FISH is a noninvasive adjuvant method foRthe diagnosis of SUC.