Department of Pathology, Yeditepe University Faculty of Medicine, ISTANBUL, TURKEY.
Turk Patoloji Derg. 2021;37(1):26-31. doi: 10.5146/tjpath.2020.01497.
Micropapillary urothelial carcinoma is an aggressive variant of urothelial carcinoma. Evidence suggests that the relationship between the tumor and inflammatory cells is important in tumor progression and the treatment response. We evaluated the stromal lymphoid response in micropapillary urothelial carcinomas and compared it with conventional urothelial carcinomas.
Among bladder transurethral resection materials diagnosed as 'invasive urothelial carcinoma' between January 2010-March 2017, cases with at least 5% micropapillary urothelial carcinoma were evaluated for age, gender, grade, stage, micropapillary urothelial carcinoma percentage, presence/percentage of accompanying conventional urothelial carcinoma/urothelial carcinoma variants, in situ urothelial carcinoma/micropapillary urothelial carcinoma, lymphovascular invasion, necrosis, and stromal lymphoid response. Stromal lymphoid response was scored as 0-1-2-3. All parameters were evaluated in 50 pure conventional urothelial carcinomas.
Among 47 micropapillary urothelial carcinomas, 41 were male. The mean age was 69 years. pT1/pT2 was 23/24. Six cases were pure MPUC. Lymphovascular invasion was present in 8, necrosis in 9 cases. Stromal lymphoid response was present and scored as 1-2-3 in 32 micropapillary urothelial carcinomas (68.1%) and 48 conventional urothelial carcinomas (96%). Micropapillary urothelial carcinomas had significantly higher lymphovascular invasion and pT2 rates and lower stromal lymphoid response.
Low stromal lymphoid response in micropapillary urothelial carcinomas can be responsible for the poor clinical outcome and impaired response to treatment of these tumors. This is the first study in the English literature to demonstrate a lower stromal lymphoid response rate in micropapillary urothelial carcinomas compared to conventional urothelial carcinomas.
微乳头状尿路上皮癌是尿路上皮癌的一种侵袭性变体。有证据表明，肿瘤与炎症细胞之间的关系在肿瘤进展和治疗反应中很重要。我们评估了微乳头状尿路上皮癌中的基质淋巴反应，并将其与传统尿路上皮癌进行了比较。
在 2010 年 1 月至 2017 年 3 月期间，对经膀胱经尿道切除材料诊断为“浸润性尿路上皮癌”的病例进行了评估，这些病例中至少有 5%的微乳头状尿路上皮癌。评估的参数包括年龄、性别、分级、分期、微乳头状尿路上皮癌的百分比、是否存在/常规尿路上皮癌/尿路上皮癌变异的百分比、原位尿路上皮癌/微乳头状尿路上皮癌、淋巴血管侵犯、坏死和基质淋巴反应。基质淋巴反应评分 0-1-2-3。在 50 例纯常规尿路上皮癌中评估了所有参数。
在 47 例微乳头状尿路上皮癌中，41 例为男性。平均年龄为 69 岁。pT1/pT2 为 23/24。6 例为纯 MPUC。8 例存在淋巴血管侵犯，9 例存在坏死。32 例微乳头状尿路上皮癌（68.1%）和 48 例常规尿路上皮癌（96%）中存在基质淋巴反应，且评分分别为 1-2-3。微乳头状尿路上皮癌的淋巴血管侵犯和 pT2 率明显较高，而基质淋巴反应明显较低。
微乳头状尿路上皮癌中基质淋巴反应较低可能是这些肿瘤临床结局较差和对治疗反应不佳的原因。这是在英文文献中首次证明与常规尿路上皮癌相比，微乳头状尿路上皮癌中的基质淋巴反应率较低。
