Translational milestones in urologic pathology: integrating molecular diagnostics across cancer types

IF 3.7 2区 医学 Q1 PATHOLOGY
Andres Matoso, Andres M Acosta
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Abstract

In its first decade, The Journal of Pathology: Clinical Research has become a leading source of translational studies advancing molecular diagnostics in cancer, particularly in urologic pathology. This commentary highlights recent contributions that collectively place precision oncology at the forefront of pathology research. One review examines cancer stem cells in renal cell carcinoma, emphasizing the complexity of cellular plasticity and the tumor microenvironment in driving resistance and recurrence. In prostate cancer, epithelial-to-mesenchymal transition (EMT) regulators, including Twist, Slug, and Snail, are identified as synergistic markers of poor prognosis, linked to hypoxia and invasiveness. Another review details the integration of homologous recombination repair gene testing into clinical workflows, supporting targeted treatment strategies with poly (ADP-ribose) polymerase inhibitors. In pediatric oncology, TP53 alterations in Wilms tumor are shown to occur beyond anaplastic cases, expanding their prognostic significance. Advances in molecular subtyping are also demonstrated in bladder cancer, where transcriptomic profiling could enable tailored neoadjuvant therapy. In clear cell renal cell carcinoma, re-evaluation of a prognostic model revealed that while necrosis or sarcomatoid differentiation correlated with poor outcomes, only DNA methylation markers improved prognostic accuracy, underscoring their utility for biopsy-based risk stratification. Finally, digital spatial profiling of sarcomatoid urothelial carcinoma reveals an immunosuppressive microenvironment with CD163-positive cells, implicating them in EMT and aggressive phenotype. Together, these studies highlight the transformative role of integrated molecular diagnostics in guiding individualized therapies and improving outcomes in urologic cancers.

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泌尿系统病理学的翻译里程碑:整合跨癌症类型的分子诊断
在第一个十年里,《病理学杂志:临床研究》已经成为推动癌症分子诊断的转化研究的主要来源,特别是在泌尿系统病理学方面。这篇评论强调了最近的贡献,这些贡献共同将精确肿瘤学置于病理学研究的前沿。一篇综述研究了肾细胞癌中的肿瘤干细胞,强调了细胞可塑性和肿瘤微环境在驱动耐药和复发中的复杂性。在前列腺癌中,上皮-间质转化(EMT)调节因子,包括Twist、Slug和Snail,被认为是不良预后的协同标志物,与缺氧和侵袭性有关。另一篇综述详细介绍了同源重组修复基因检测与临床工作流程的整合,支持多聚(adp -核糖)聚合酶抑制剂的靶向治疗策略。在儿科肿瘤学中,除了间变性病例外,Wilms肿瘤中TP53的改变也出现,这扩大了其预后意义。分子分型的进展也在膀胱癌中得到证实,转录组分析可以使量身定制的新辅助治疗成为可能。在透明细胞肾细胞癌中,对预后模型的重新评估显示,虽然坏死或肉瘤样分化与预后不良相关,但只有DNA甲基化标记提高了预后准确性,强调了它们在基于活检的风险分层中的作用。最后,肉瘤样尿路上皮癌的数字空间分析揭示了cd163阳性细胞的免疫抑制微环境,暗示它们与EMT和侵袭性表型有关。总之,这些研究强调了综合分子诊断在指导个体化治疗和改善泌尿系统癌症预后方面的变革性作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Pathology Clinical Research
Journal of Pathology Clinical Research Medicine-Pathology and Forensic Medicine
CiteScore
7.40
自引率
2.40%
发文量
47
审稿时长
20 weeks
期刊介绍: The Journal of Pathology: Clinical Research and The Journal of Pathology serve as translational bridges between basic biomedical science and clinical medicine with particular emphasis on, but not restricted to, tissue based studies. The focus of The Journal of Pathology: Clinical Research is the publication of studies that illuminate the clinical relevance of research in the broad area of the study of disease. Appropriately powered and validated studies with novel diagnostic, prognostic and predictive significance, and biomarker discover and validation, will be welcomed. Studies with a predominantly mechanistic basis will be more appropriate for the companion Journal of Pathology.
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