Stenzl - Figure 14
Overlaps of UNC, MDA, TCGA, and Lund Subtype Classification Systems in MIBC Tumors
FIG. 14: Apart from the Swedish classification,[3] other classifications have been proposed, the most important of all probably being the TCGA system.[2] They have all demonstrated a more aggressive form of urothelial cancer, which has been called basal tumors by the University of North Carolina (UNC)[4] and the MD Anderson Cancer Center (MDA)[5] classifications, cluster III and IV by the TCGA,[2] and urothelial B or squamous cell-like cancers by the Lund system[3] (see Figure[6,7])
The prognostically more favorable tumors would be luminal tumors in the UNC[4] and MDA[5] classifications, cluster I or II in the TCGA system,[2] and urobasal A (UroA) and genomically unstable (Genom Unst) in the Lund classification.[2]
Apart from the more aggressive tumors and tumors with a more favorable prognosis, there are subtypes in some of these systems that are based on the increased epithelial–mesenchymal transition activity and the infiltration activity in the more aggressive tumors, whereas genomically unstable tumors make the favorable class a little less favorable.[7] These classifications help physicians develop a better picture at the initial prognostic evaluation of a tumor, and guide decision-making between a more aggressive versus a more conservative form of treatment.
References
The Cancer Genome Atlas Research Network. Comprehensive molecular characterization of urothelial bladder carcinoma. Nature. 2014:507:315−22 nature.com/doifinder/10.1038/nature12965
Sjödahl G, Lauss M, Lövgren K, Chebil G, et al. A molecular taxonomy for urothelial carcinoma. Clin Cancer Res. 2012;18:3377−86 https://doi.org/10.1158/1078-0432.CCR-12-0077-T
Damrauer JS, Hoadley KA, Chism DD, et al. Intrinsic subtypes of high-grade bladder cancer reflect the hallmarks of breast cancer biology. Proc Natl Acad Sci U S A. 2014;25:3110–5 https://doi.org/10.1073/pnas.1318376111
Choi W, Porten S, Kim S, et al. Identification of distinct basal and luminal subtypes of muscle-invasive bladder cancer with different sensitivities to frontline chemotherapy. Cancer Cell. 25, 152–65 http://dx.doi.org/10.1016/j.ccr.2014.01.009
Aine M, Eriksson P, Liedberg F, et al. Biological determinants of bladder cancer gene expression subtypes. Sci Rep. 2015;5:10957 https://doi.org/10.1038/srep10957
Aine M, Eriksson P, Liedberg F, et al. On molecular classification of bladder cancer: Out of one, many. Eur Urol. 2015;68:921−3 http://dx.doi.org/10.1016/j.eururo.2015.07.021
