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Diagnostic algorithm for papillary urothelial tumors in the urinary bladder.

 Jung-Weon Shim  ;  Kang Su Cho  ;  Young-Deuk Choi  ;  Yong-Wook Park  ;  Dong-Wha Lee  ;  Woon-Sup Han  ;  Sang-In Shim  ;  Hyun-Jung Kim  ;  Nam Hoon Cho 
 VIRCHOWS ARCHIV, Vol.452(4) : 353-362, 2008 
Journal Title
Issue Date
Algorithms ; Biomarkers, Tumor/metabolism ; Carcinoma,Papillary/classification ; Carcinoma,Papillary/diagnosis* ; Carcinoma,Papillary/pathology* ; Carcinoma, Transitional Cell/classification ; Carcinoma, Transitional Cell/diagnosis ; Carcinoma, Transitional Cell/pathology ; Disease Progression ; Humans ; Ion Channels ; Keratin-20/metabolism ; Membrane Proteins/metabolism ; Mitotic Index ; Neoplasm Recurrence, Local/diagnosis ; Neoplasm Recurrence, Local/pathology ; Tumor Suppressor Protein p53/metabolism ; Urinary BladderNeoplasms/classification ; Urinary BladderNeoplasms/diagnosis* ; Urinary BladderNeoplasms/pathology* ; Urothelium/metabolism ; Urothelium/pathology*
Papillary urothelial neoplasm of low malignant potential ; Recurrence ; MIB
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.
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1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Cho, Kang Su(조강수) ORCID logo https://orcid.org/0000-0002-3500-8833
Cho, Nam Hoon(조남훈) ORCID logo https://orcid.org/0000-0002-0045-6441
Choi, Young Deuk(최영득) ORCID logo https://orcid.org/0000-0002-8545-5797
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