Hierro Martín I, Alvarez Pérez M, Blanes Berenguel A, Quiñonero Díaz A, Díaz Cano S, García González I, Matilla Vicente A
Dpto. de Anatomía Patológica, Facultad de Medicina, Universidad de Málaga.
Actas Urol Esp. 1999 Jun;23(6):489-96.
TCCs are an heterogenous group of tumors with an uncertain biologic behaviour, especially intermediate grade (G2). Histologic grade and pathologic stage have revealed only partially useful on predicting the outcome.
Search and statement of objective and cuantitative parameters able to define prognostic subgroups to TCCs.
We studied consecutive 106 patients with TCC in order to: 1) Identify every variable with independent predictive value in classifying cases of TCC in a three (1,2,3) or two (high/low) grades systems. 2) Make a correlation between DNA ploidy obtained by image analysis and DNA ploidy and S-phase obtained by flow cytometry.
Every variable used to define the histologic grade showed significative correlation with both gradation systems. In multivariate analysis, the presence of superficial cells and the mitotic counts revealed us the most valuable variables in predicting the histologic grade. DNA-ploidy (both obtained by static an flow cytometry) correlated well with grade, stage, growth pattern and necrosis, whereas S-phase did so with grade, mitotic index and DNA ploidy. Image cytometry showed similars results to those of flow cytometry and also was able to detect aneuploidy when an situ carcinoma or dysplasia were present in the adyacent mucosa.
移行细胞癌是一组生物学行为不确定的异质性肿瘤，尤其是中级别（G2）肿瘤。组织学分级和病理分期在预测预后方面仅部分有用。
寻找并阐述能够定义移行细胞癌预后亚组的客观和定量参数。
我们研究了连续106例移行细胞癌患者，以便：1）在三级（1、2、3）或两级（高/低）分级系统中确定在移行细胞癌病例分类中具有独立预测价值的每个变量。2）对通过图像分析获得的DNA倍体与通过流式细胞术获得的DNA倍体和S期进行相关性分析。
用于定义组织学分级的每个变量与两种分级系统均显示出显著相关性。在多变量分析中，表层细胞的存在和有丝分裂计数是预测组织学分级中最有价值的变量。DNA倍体（通过静态和流式细胞术获得）与分级、分期、生长模式和坏死密切相关，而S期与分级、有丝分裂指数和DNA倍体密切相关。图像细胞术显示的结果与流式细胞术相似，并且当相邻黏膜存在原位癌或发育异常时也能够检测到非整倍体。
