Department of Pathology, Hôpital La Pitié-Salpétrière, Assistance-Publique Hôpitaux de Paris, Université Pierre et Marie Curie University Paris VI, 47-83, Bd de l'Hôpital, 75013 Paris, France.
Virchows Arch. 2013 Mar;462(3):343-8. doi: 10.1007/s00428-013-1378-4. Epub 2013 Feb 10.
Urothelial carcinoma in situ (CIS) is a high-grade lesion with different subtypes (large cell pleomorphic (LCP), large cell nonpleomorphic (LC), small cell and clinging (CL)). We explored the frequency of different subtypes in primary CIS and compared different patterns with outcome. We explored whether subtyping of CIS leads to a change in therapy and/or follow-up and should be formally reported. We included 39 patients with a primary CIS and divided them into two groups: one with LPC/LG and one with CL elements. Other subtypes did not exist or occurred only as a mixture. Patient age ranged from 36 to 80 years (mean, 63 years). Twenty had a primary CIS with one single subtype. LCP was predominant with 16 (41 %) cases; the second most important subtype was the CL with four (10 %) cases. Mean follow-up was 26.4 months, (range, 4-100 months). Thirteen patients developed a ≥ pT2 carcinoma. When progression of the different subtypes was examined, no statistical significance was found between mixed forms (p = 0.9437) nor between pure forms (p = 0.744 and p = 0.5955, respectively). Pathologists need not include different subtypes of primary CIS in their report as there is no difference in patient outcomes. It is important to recognize all different subtypes as CIS for best patient treatment.
原位尿路上皮癌 (CIS) 是一种高级别病变，具有不同的亚型（大细胞多形性 (LCP)、大细胞非多形性 (LC)、小细胞和贴壁 (CL)）。我们探讨了原发性 CIS 中不同亚型的频率，并比较了不同模式与结局的关系。我们探讨了 CIS 的亚型分类是否会导致治疗和/或随访方式的改变，以及是否应正式报告。我们纳入了 39 例原发性 CIS 患者，并将其分为两组：一组为 LPC/LG 型，一组为 CL 型。其他亚型不存在或仅以混合形式存在。患者年龄 36-80 岁（平均 63 岁）。20 例为单一单一亚型原发性 CIS。LCP 占主导地位，有 16 例（41%）；其次是 CL，有 4 例（10%）。平均随访时间为 26.4 个月（范围 4-100 个月）。13 例患者发展为≥pT2 癌。当检查不同亚型的进展时，混合形式之间（p=0.9437）和纯形式之间（p=0.744 和 p=0.5955）均无统计学差异。病理学家无需在报告中纳入原发性 CIS 的不同亚型，因为患者结局无差异。认识到所有不同的 CIS 亚型对于最佳的患者治疗非常重要。
