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Håkan Axelson

Håkan Axelson

Research team manager

Håkan Axelson

The Lund taxonomy for bladder cancer classification – from gene expression clustering to cancer cell molecular phenotypes, and back again


  • Mattias Höglund
  • Carina Bernardo
  • Gottfrid Sjödahl
  • Pontus Eriksson
  • Håkan Axelson
  • Fredrik Liedberg

Summary, in English

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.


  • Urothelial Cancer Genomics
  • LUCC: Lund University Cancer Centre
  • Division of Translational Cancer Research
  • Kidney cancer research group
  • Department of Laboratory Medicine
  • Urology - urothelial cancer, Malmö
  • Urothelial cancer

Publishing year







Journal of Pathology





Document type

Journal article review


John Wiley & Sons Inc.


  • Cancer and Oncology


  • bladder cancer
  • gene expression profiling
  • molecular classification
  • molecular pathology



Research group

  • Urothelial Cancer Genomics
  • Kidney cancer research group
  • Urology - urothelial cancer, Malmö


  • ISSN: 0022-3417