Cheville J C, Wu K, Sebo T J, Cheng L, Riehle D, Lohse C M, Shane V
Department of Pathology and Laboratory Medicine, Mayo Clinic, Rochester, MN 55905, USA.
Cancer. 2000 Feb 1;88(3):632-6. doi: 10.1002/(sici)1097-0142(20000201)88:3<632::aid-cncr21>3.0.co;2-f.
Inverted urothelial papilloma is an unusual neoplasm of the urinary tract. Although the association between inverted urothelial papilloma and urothelial carcinoma is not entirely clear, many studies indicate that patients with inverted papilloma are at increased risk for the development of urothelial carcinoma. In addition, aneuploid inverted papillomas have been associated with the subsequent development of urothelial carcinoma. The objective of this study was to determine whether ploidy, MIB-1 proliferative activity, or p53 protein staining in inverted papilloma were predictive of urothelial carcinoma.
Fifty-one cases of inverted papilloma were retrieved from the Tissue Registry of the Mayo Clinic. Clinical records were reviewed for patient age, length of follow-up, and history of urothelial carcinoma (defined as carcinoma prior to, concurrent with, or subsequent to the diagnosis of inverted papilloma). DNA ploidy analysis was determined using Feulgen stained sections from paraffin embedded tissues using an image analysis system. Quantitation of MIB-1 proliferative activity and p53 immunostaining was determined similarly using immunoperoxidase stained sections from paraffin embedded tissues.
The mean age at diagnosis of inverted papilloma was 63.9 years (range, 37-87 years), and there were 39 men and 12 women. Patients were followed for a mean of 56.5 months (range, 1-252 months). Tumors ranged in size from 0.2 to 4.3 cm (mean, 0.9 cm). Eight patients (15.7%) had a prior, concurrent, or subsequent noninvasive World Health Organization and International Society of Urologic Pathology (WHO/ISUP) papillary neoplasm of low malignant potential or papillary carcinoma of low grade (formerly WHO Grade 1 or 2 papillary urothelial carcinoma). Inverted papillomas in patients with a history of urothelial carcinoma were all diploid and had a mean MIB-1 activity of 6.3% (range, 0.04-24.8%) and mean p53 protein staining of 12.6% (range, 0.5-24.9%). These inverted papillomas ranged in size from 0.3 to 1.0 cm (mean, 0.5 cm). Inverted papillomas in patients without a history of urothelial carcinoma were aneuploid in 6 cases (14.3%) and diploid in the remaining cases. These inverted papillomas had a mean MIB-1 activity of 1.6% (range, 0.06-9.0%) and mean p53 protein staining of 9.7% (range, 0.05-38.0%). Tumor size ranged from 0.2 to 4.3 cm (mean, 1.0 cm). There were no statistically significant differences in MIB-1 activity, p53 protein staining, ploidy, and morphologic features between inverted papillomas in patients with and without a history of urothelial carcinoma.
Ploidy, MIB-1 proliferative activity, and p53 immunostaining in inverted urothelial papilloma were not useful in identifying patients who had a history of urothelial carcinoma.
内翻性尿路上皮乳头状瘤是一种不常见的泌尿道肿瘤。虽然内翻性尿路上皮乳头状瘤与尿路上皮癌之间的关联尚不完全清楚，但许多研究表明，内翻性乳头状瘤患者发生尿路上皮癌的风险增加。此外，非整倍体性内翻性乳头状瘤与随后发生尿路上皮癌有关。本研究的目的是确定内翻性乳头状瘤中的倍体、MIB-1增殖活性或p53蛋白染色是否可预测尿路上皮癌。
从梅奥诊所组织登记处检索出51例内翻性乳头状瘤病例。查阅临床记录，了解患者年龄、随访时间以及尿路上皮癌病史（定义为在内翻性乳头状瘤诊断之前、同时或之后发生的癌）。使用图像分析系统，对石蜡包埋组织的福尔根染色切片进行DNA倍体分析。同样，使用石蜡包埋组织的免疫过氧化物酶染色切片，对MIB-1增殖活性和p53免疫染色进行定量分析。
内翻性乳头状瘤诊断时的平均年龄为63.9岁（范围37 - 87岁），男性39例，女性12例。患者平均随访56.5个月（范围1 - 252个月）。肿瘤大小范围为0.2至4.3 cm（平均0.9 cm）。8例患者（15.7%）有既往、同时或随后发生的世界卫生组织和国际泌尿病理学会（WHO/ISUP）低恶性潜能乳头状肿瘤或低级别乳头状癌（以前的WHO 1级或2级乳头状尿路上皮癌）。有尿路上皮癌病史患者的内翻性乳头状瘤均为二倍体，MIB-1活性平均为6.3%（范围0.04 - 24.8%），p53蛋白染色平均为12.6%（范围0.5 - 24.9%）。这些内翻性乳头状瘤大小范围为0.3至1.0 cm（平均0.5 cm）。无尿路上皮癌病史患者的内翻性乳头状瘤6例（14.3%）为非整倍体，其余为二倍体。这些内翻性乳头状瘤MIB-1活性平均为1.6%（范围0.06 - 9.0%），p53蛋白染色平均为9.7%（范围0.05 - 38.0%）。肿瘤大小范围为0.2至4.3 cm（平均1.0 cm）。有和无尿路上皮癌病史患者的内翻性乳头状瘤在MIB-1活性、p53蛋白染色、倍体和形态学特征方面无统计学显著差异。
内翻性尿路上皮乳头状瘤中的倍体、MIB-1增殖活性和p5
