Level of mitoses in non-muscle invasive papillary urothelial carcinomas (pTa and pT1) at initial bladder biopsy is a simple and powerful predictor of clinical outcome: a multi-center study in South Korea
| Autor: | Young A Kim, Dae Yong Kang, Yong Mee Cho, Jung dong Lee, Ji Eun Kwon, So Dug Lim, Sun-Young Jun, Nam Hoon Cho, Yeong Jin Choi, Hyun-Jung Kim, Mi Sun Choe, Sung Sun Kim, Jae Y. Ro, Sanghui Park |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Male
Pathology medicine.medical_specialty Histology Biopsy 030232 urology & nephrology Mitosis Logistic regression Pathology and Forensic Medicine Surgical pathology 03 medical and health sciences 0302 clinical medicine Mitotic level Republic of Korea medicine lcsh:Pathology Humans Papillary urothelial carcinoma Aged Neoplasm Grading Carcinoma Transitional Cell medicine.diagnostic_test Clinical pathology business.industry Clinical outcome Research Predictor Papillary urothelialcarcinoma General Medicine Middle Aged Prognosis Bladder Biopsy Urinary Bladder Neoplasms 030220 oncology & carcinogenesis Disease Progression Female business lcsh:RB1-214 |
| Zdroj: | Diagnostic Pathology, Vol 12, Iss 1, Pp 1-12 (2017) Diagnostic Pathology DIAGNOSTIC PATHOLOGY(12) |
| ISSN: | 1746-1596 |
| DOI: | 10.1186/s13000-017-0639-y |
| Popis: | Background Histologic grade is the most important predictor of the clinical outcome of non-muscle invasive (Ta, T1) papillary urothelial carcinoma (NMIPUCa), but its ambiguous criteria diminish its power to predict recurrence/progression for individual patients. We attempted to find an objective and reproducible histologic predictor of NMIPUCa that correlates well with the clinical outcome. Methods A total of 296 PUCas were collected from the Departments of Surgical Pathology of 11 institutions in South Korea. The clinical outcome was grouped into no event (NE), recurrence (R), and progression (P) categories. All 25 histological parameters were numerically redefined. The clinical pathology of each case was reviewed individually by 11 pathologists from 11 institutions based on the 2004 WHO criteria and afterwards blindly evaluated by two participants, based on our proposed parameters. Univariate and multivariate logistic regression analyses were performed using the R software package. Results The level of mitoses was the most reliable parameter for predicting the clinical outcome. We propose a four-tiered grading system based on mitotic count (> 10/10 high-power fields), nuclear pleomorphism (smallest-to-largest ratio of tumor nuclei >20), presence of divergent histology, and capillary proliferation (> 20 capillary lumina per papillary core). Conclusions The level of mitoses at the initial bladder biopsy and transurethral resection (TUR) specimen appeared to be an independent predictor of the Ta PUCa outcome. Other parameters include the number of mitoses, nuclear pleomorphism, divergent histology, and capillary proliferation within the fibrovascular core. These findings may improve selection of patients for a therapeutic strategy as compared to previous grading systems. Electronic supplementary material The online version of this article (doi:10.1186/s13000-017-0639-y) contains supplementary material, which is available to authorized users. |
| Databáze: | OpenAIRE |
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