Lopez-Beltran Antonio, Montironi Rodolfo
Department of Pathology, Reina Sofia University Hospital and Cordoba University Medical School, Faculty of Medicine, Avda. Menendez Pidal S/N, 14004 Cordoba, Spain.
Eur Urol. 2004 Aug;46(2):170-6. doi: 10.1016/j.eururo.2004.03.017.
The key points of the latest World Health Organization (WHO) classification of non-invasive urothelial tumors are: the description of the categories has been expanded in the current version to improve their recognition; one group (papillary urothelial neoplasm of low malignant potential) with particularly good prognosis does not carry the label of 'cancer'; it avoids use of ambiguous grading such as grade 1/2 or 2/3 (according to the WHO classification published in 1973, i.e., 1973 WHO classification); the group of non-invasive high grade carcinoma is large enough to contain virtually all those tumors that have biological properties (and a high level of genetic instability) similar to those seen in invasive urothelial carcinoma. This scheme is meant to replace the 1973 WHO classification. Changes in classification have their own inherent problems, tending to lead to confusion, at least for a period of time. From the practical point of view, the use of both the 1973 and the latest WHO classifications is recommended until the latter is sufficiently validated.
世界卫生组织(WHO)最新的非侵袭性尿路上皮肿瘤分类要点如下:在当前版本中,类别描述已得到扩充,以提高其辨识度;一组预后特别好的肿瘤(低恶性潜能乳头状尿路上皮肿瘤)不带有“癌”的标签;避免使用如1/2级或2/3级这样模糊的分级(根据1973年发布的WHO分类,即1973年WHO分类);非侵袭性高级别癌这一组足够大,实际上包含了所有具有与侵袭性尿路上皮癌相似生物学特性(以及高度遗传不稳定性)的肿瘤。该方案旨在取代1973年WHO分类。分类的变化有其自身固有的问题,至少在一段时间内往往会导致混淆。从实际角度出发,建议在最新的WHO分类得到充分验证之前,同时使用1973年和最新的WHO分类。