摘要
目的比较非浸润性膀胱尿路上皮癌WHO 2004年和1973年病理分级方法的临床应用价值。方法采用WHO 2004和19732种病理分级方法对160例非浸润性膀胱尿路上皮癌患者进行病理分级，随访患者复发和进展情况，比较分析2种分级系统临床应用差异。结果160例患者按1973分级方法：乳头状瘤5例，尿路上皮癌G1 52例、G2 83例、G3 20例；按2004分级法：乳头状瘤7例，低度恶性潜能尿路上皮乳头状瘤（PUNLMP）31例、低分级尿路上皮乳头状癌（LGPUC）99例、高分级尿路上皮乳头状癌（HGPUC）23例。1973分级法各级别间复发与进展情况差异均无统计学意义（P〉0．05）；2004分级法各级别间复发差异无统计学意义（P〉0．05），进展情况差异有统计学意义（P〈0．05），其中PUNLMP与HGPUC差异有统计学意义（P〈0．01）。2004分级法HGPUC级别进展率（30．4％）明显高于1973分级法G3级别进展率（15．0％）。结论WHO2004分级法中HGPUC级别衍含更多的高度恶性尿路上皮细胞癌，较1973分级法G3级别更容易发生进展，临床上对HGPUC级别患者应采用更严密的治疗和随访措施。
Objective To compare WHO 2004 and WHO 1973 pathological grading methods of non-muscle invasive urothelial neoplasms. Methods The clinical pathological features of 160 non- muscle invasive urothelial neoplasms patients, treated in our hospital from February, 1998 to December, 2008, were re-graded according to WHO 2004 and WHO 1973 classification system. To evaluate recurrence and progression of all the patients during the follow up period, we used statistical method to analyses the differences between two classification system. Results There were 160 patients, according to WHO 1973 classification methods： 5 cases of papilloma, 52 cases of grade 1 tumors, 83 ca ses of grade 2 and 20 cases of grade 3;By WHO 2004 classification method： 7 cases of papilloma, 31 cases of low-grade malignant potential of urothelial papilloma, 99 cases of low-grade papillary urotheli al carcinoma and 23 cases of high-grade papillary urothelial carcinoma. There was no difference in re currence among the grades of WHO 2004 and WHO 1973 pathological grading system （both P〉 0.05）. Regarding the progress of non-muscle invasive papillary urothelial neoplasms, no significant difference was found among grades of WHO 1973 classification system（P〉0.05）while difference existed among grades of WHO 2004 pathological grading system （P〈0.05）, especially between papillary neoplasm of low malignant potential （PNLMP） and high grade papillary urothelial carcinomas（HGPUC） （P〈〈0.01 ）. Moreover, HGPUC grade had more progression rate （30.4 %） than G3 grade （ 15. 0%）. Conclusions Compare to G3 grade, HGPUC grade was more easily to make progress in patients,due to this grade include more high malignant papillary urothelial carcinomas. Therefore, it is necessary for urologists to use a more rigorously follow up and therapy method in connection with HGPUC grade of new classification system.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2010年第2期104-106,共3页
Chinese Journal of Urology
关键词
膀胱肿瘤
病理分级
临床应用
Bladder neoplasms
Pathological grading
Clinical application
