The Lund taxonomy for bladder cancer classification – from gene expression clustering to cancer cell molecular phenotypes, and back again
(2023) In Journal of Pathology 259(4). p.369-375- Abstract
Treatment of bladder cancer patients depends on precise diagnosis. Molecular subtyping by gene expression profiling may contribute substantially to subclassification of bladder cancer. Several classification systems have been proposed. Most of these base their classification on whole biopsy features, and molecular subtypes are therefore often defined by a combination of features from the cancer cells as well as infiltrating noncancer cells. This makes the link to what is seen at the cancer cell level unclear. The aim of the Lund taxonomy (LundTax) has been to align gene expression-level classification with immunohistochemical classification to identify cancer cell phenotypes independent of infiltration and proliferation. A systematic... (More)
Treatment of bladder cancer patients depends on precise diagnosis. Molecular subtyping by gene expression profiling may contribute substantially to subclassification of bladder cancer. Several classification systems have been proposed. Most of these base their classification on whole biopsy features, and molecular subtypes are therefore often defined by a combination of features from the cancer cells as well as infiltrating noncancer cells. This makes the link to what is seen at the cancer cell level unclear. The aim of the Lund taxonomy (LundTax) has been to align gene expression-level classification with immunohistochemical classification to identify cancer cell phenotypes independent of infiltration and proliferation. A systematic approach was used in which gene expression clusters were validated and adjusted by immunohistochemistry using markers expressed only by the cancer cells. This review provides a rationale for defining molecular subtypes and a step-by-step description of the development of the LundTax with motivations for each modification and extension. As the cancer cell phenotype defined by gene expression profiling corresponds with the immunohistochemistry of cancer cells, the LundTax represents a harmonization of the gene expression and immunohistochemical levels. Furthermore, the classification system is independent of pathological stage and is, thus, applicable to all urothelial carcinomas. A unified classification system relevant for both the molecular biologist and pathologist will facilitate systematization of current treatment practices, as well as the development of new treatments.
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- author
- Höglund, Mattias LU ; Bernardo, Carina LU ; Sjödahl, Gottfrid LU ; Eriksson, Pontus LU ; Axelson, Håkan LU and Liedberg, Fredrik LU
- organization
- publishing date
- 2023
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- bladder cancer, gene expression profiling, molecular classification, molecular pathology
- in
- Journal of Pathology
- volume
- 259
- issue
- 4
- pages
- 369 - 375
- publisher
- John Wiley & Sons Inc.
- external identifiers
-
- pmid:36700594
- scopus:85148433369
- ISSN
- 0022-3417
- DOI
- 10.1002/path.6062
- language
- English
- LU publication?
- yes
- id
- 8d2ba07d-207e-4dec-a304-e86426115d67
- date added to LUP
- 2023-03-07 14:57:49
- date last changed
- 2024-09-19 08:47:26
@article{8d2ba07d-207e-4dec-a304-e86426115d67, abstract = {{<p>Treatment of bladder cancer patients depends on precise diagnosis. Molecular subtyping by gene expression profiling may contribute substantially to subclassification of bladder cancer. Several classification systems have been proposed. Most of these base their classification on whole biopsy features, and molecular subtypes are therefore often defined by a combination of features from the cancer cells as well as infiltrating noncancer cells. This makes the link to what is seen at the cancer cell level unclear. The aim of the Lund taxonomy (LundTax) has been to align gene expression-level classification with immunohistochemical classification to identify cancer cell phenotypes independent of infiltration and proliferation. A systematic approach was used in which gene expression clusters were validated and adjusted by immunohistochemistry using markers expressed only by the cancer cells. This review provides a rationale for defining molecular subtypes and a step-by-step description of the development of the LundTax with motivations for each modification and extension. As the cancer cell phenotype defined by gene expression profiling corresponds with the immunohistochemistry of cancer cells, the LundTax represents a harmonization of the gene expression and immunohistochemical levels. Furthermore, the classification system is independent of pathological stage and is, thus, applicable to all urothelial carcinomas. A unified classification system relevant for both the molecular biologist and pathologist will facilitate systematization of current treatment practices, as well as the development of new treatments.</p>}}, author = {{Höglund, Mattias and Bernardo, Carina and Sjödahl, Gottfrid and Eriksson, Pontus and Axelson, Håkan and Liedberg, Fredrik}}, issn = {{0022-3417}}, keywords = {{bladder cancer; gene expression profiling; molecular classification; molecular pathology}}, language = {{eng}}, number = {{4}}, pages = {{369--375}}, publisher = {{John Wiley & Sons Inc.}}, series = {{Journal of Pathology}}, title = {{The Lund taxonomy for bladder cancer classification – from gene expression clustering to cancer cell molecular phenotypes, and back again}}, url = {{http://dx.doi.org/10.1002/path.6062}}, doi = {{10.1002/path.6062}}, volume = {{259}}, year = {{2023}}, }