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Diagnostic algorithm for papillary urothelial tumors in the urinary bladder

Title
Diagnostic algorithm for papillary urothelial tumors in the urinary bladder
Authors
Shim J.-W.Cho K.S.Choi Y.-D.Park Y.-W.Lee D.-W.Han W.-S.Shim S.-I.Kim H.-J.Cho N.H.
Ewha Authors
한운섭
SCOPUS Author ID
한운섭scopusscopus
Issue Date
2008
Journal Title
Virchows Archiv
ISSN
0945-6317JCR Link
Citation
vol. 452, no. 4, pp. 353 - 362
Indexed
SCI; SCIE; SCOPUS WOS scopus
Abstract
Papillary urothelial neoplasms with deceptively bland cytology cannot be easily classified. We aimed to design a new algorithm that could differentiate between these neoplasms based on a scoring system. We proposed a new scoring system that enables to reproducibly diagnose non-invasive papillary urothelial tumors. In this system, each lesion was given individual scores from 0 to 3 for mitosis and cellular thickness, from 0 to 2 for cellular atypia, and an additional score for papillary fusion. These scores were combined to form a summed score allowing the tumors to be ranked as follows: 0-1 = UP, 2-4 = low malignant potential (LMP), 5-7 = low-grade transitional cell carcinoma (TCC), and 8-9 = high-grade TCC. In addition to the scoring system, ancillary studies of MIB and p53 indexes with CK20 expression pattern analyses were compared together with clinical parameters. The MIB index was strongly correlated with disease progression. Four of the 22 LMP patients (18.2%) had late recurrences, two of these four (9.1%) had progression to low-grade carcinoma. The MIB index for LMP patients was strongly associated with recurrence (recurrence vs. non-recurrence, 16.5 vs. 8.1, p<0.001). The proposed scoring system could enhance the reproducibility to distinguish papillary urothelial neoplasms. © 2008 Springer-Verlag.
DOI
10.1007/s00428-008-0585-x
Appears in Collections:
의과대학 > 의학과 > Journal papers
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