Helpap B, Köllermann J
Institut für Pathologie, Hegau-Klinikum GmbH Singen, Akademisches Lehrkrankenhaus, Universität Freiburg.
Pathologe. 2000 May;21(3):211-7. doi: 10.1007/s002920050390.
Recently the World Health Organization published a new classification of urinary bladder tumors which is intended to take into account better the biology of the various lesions and to better distinguish between clearly benign and malignant lesions. We examine the possible diagnostic and clinical impact of the new classification, including recent immunohistochemical findings. Papillary urothelial lesions include papillomas, papillary neoplasms of low malignant potential, and papillary carcinomas. Flat urothelial lesions include hyperplasia, reactive atypia/atypia of unknown significance, dysplasia, and carcinoma in situ. Invasive patterns of papillary carcinomas are discussed, with special emphasis on lamina muscularis mucosae substaging. The most important feature of the new classification is its differentiation of two types of low-grade, noninvasive papillary urothelial lesions: papillary neoplasm of low malignant potential vs. papillary carcinoma. Long-term follow-up studies are needed to determine the clinical significance of this differentiation.
最近，世界卫生组织发布了膀胱肿瘤的新分类，旨在更好地考虑各种病变的生物学特性，并更清晰地区分明显的良性和恶性病变。我们研究了新分类可能产生的诊断和临床影响，包括近期免疫组化研究结果。乳头状尿路上皮病变包括乳头状瘤、低恶性潜能乳头状肿瘤和乳头状癌。扁平尿路上皮病变包括增生、反应性异型增生/意义不明的异型增生、发育异常和原位癌。文中讨论了乳头状癌的浸润模式，特别强调了黏膜肌层的亚分期。新分类的最重要特征是区分了两种低级别、非浸润性乳头状尿路上皮病变：低恶性潜能乳头状肿瘤与乳头状癌。需要进行长期随访研究以确定这种区分的临床意义。
