Department of Pathology, Hacettepe University School of Medicine, Ankara, Turkey.
Clinic of Pathology, Mardin State Hospital, Mardin, Turkey.
Balkan Med J. 2017 Sep 29;34(5):464-468. doi: 10.4274/balkanmedj.2017.0081. Epub 2017 Apr 13.
To evaluate the impact of a histologically inverted pattern on recurrence in patients with newly diagnosed non-invasive, low-grade papillary urothelial carcinoma of the urinary bladder.
A total of 81 patients with primary bladder non-invasive, low-grade papillary urothelial carcinoma diagnosed in a single tertiary-care centre who had at least 1-year follow-up after an initial resection were included. All slides from each case were reviewed to determine the growth pattern (exophytic versus endophytic, i.e. inverted) and other histological parameters. Clinical data were retrieved from hospital records.
Disease recurrence occurred in 41 (50.6%) patients. Cases with an inverted pattern showed a lower recurrence rate than those with pure exophytic tumours (37.5% versus 52.1%), a longer time to first recurrence (mean 34 versus 21.5 months) and fewer recurrence episodes (p=0.482, 0.564 and 0.051, respectively). All recurring inverted cases recurred only once during follow-up. No tumour with >80% inverted architecture recurred.
Our results suggest that non-invasive, low-grade papillary urothelial carcinoma of the bladder tends to have a better outcome in terms of disease recurrence if it shows an inverted growth pattern. To indicate the presence and percentage of the inverted pattern in low-grade urothelial carcinomas in the pathology report might be considered as an adjunct to help long-term patient management.
评估新诊断的非浸润性、低级别膀胱尿路上皮乳头状癌患者中组织学倒置模式对复发的影响。
共纳入 81 例在单一三级保健中心诊断为原发性膀胱非浸润性、低级别尿路上皮乳头状癌的患者，这些患者在初次切除后至少有 1 年的随访。对每个病例的所有切片进行评估，以确定生长模式（外生性与内生性，即倒置）和其他组织学参数。临床数据从医院记录中检索。
41 例（50.6%）患者出现疾病复发。倒置模式的病例复发率低于纯外生性肿瘤（37.5%比 52.1%），首次复发时间更长（平均 34 比 21.5 个月），复发次数更少（p=0.482、0.564 和 0.051）。所有复发的倒置病例在随访期间仅复发一次。没有 >80%倒置结构的肿瘤复发。
我们的结果表明，如果膀胱非浸润性、低级别尿路上皮乳头状癌显示倒置生长模式，其疾病复发的预后较好。病理报告中指出低级别尿路上皮癌中倒置模式的存在和百分比可能被认为是辅助长期患者管理的一种方法。
