Re: Bas W.G. van Rhijn, Anouk E. Hentschel, Johannes Bründl, et al. Prognostic Value of the WHO1973 and WHO2004/2016 Classification Systems for Grade in Primary Ta/T1 Non–muscle-invasive Bladder Cancer: A Multicenter European Association of Urology Non–muscle-invasive Bladder Cancer Guidelines Panel Study. Eur Urol Oncol 2021;4:182–91

Objectives Atypical cells (Atyp.C), as a new parameter determined by an automated urine analyzer, can be suspected of being malignant tumor cells. We evaluated the extent to which the Atyp.C can predict the existence of malignant tumor cells. Methods A total of 3,315 patients (1,751 in the training cohort and 1,564 in the testing cohort) were recruited and divided into five groups, namely, primary bladder cancer (BCa), recurrent BCa, post-treatment monitoring of BCa, other urological tumors, and controls. Urine Atyp. C, bacteria, white blood cell, and red blood cell were measured by a Sysmex UF-5000 analyzer. We compared the Atyp.C values across the different groups, sexes, and tumor stages. The diagnostic performance of Atyp.C alone and in combination with other parameters for detecting BCa was evaluated using receiver operating characteristic (ROC) curve analysis. Results The Atyp.C value of the primary BCa group was significantly higher than that in the other groups, except recurrent BCa group. The Atyp.C value was closely related to tumor staging. Atyp.C combined with bacteria had the highest diagnostic performance for primary BCa [training cohort AUC: 0.781 (95 % CI: 0.761–0.801); testing cohort AUC: 0.826 (95 % CI: 0.806–0.845)]. The AUC value of diagnosed recurrent BCa by Atyp.C plus bacteria for the training cohort was 0.784 (95 % CI: 0.762–0.804). Conclusions Atyp.C was high in primary BCa patients and the combination of bacteria and Atyp.C showed high predictive value for primary BCa, suggesting that Atyp.C may be a useful objective indicator for the early detection of BCa.

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Pathological Staging, Grading, and Classifi Cation of Bladder Cancer

Keser,

Kir

2024

Current Management of Non-Muscle Invasive Bladder Cancer

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The tumor, node, metastasis classification is used in the staging of bladder cancer. Although it is not yet included in current urology guidelines, the prognostic significance of the T1 substaging has been suggested in many studies. The grading of bladder cancer uses the World Health Organization’s 1973 and 2004/2022 classifications, new classifications formed by their combination are currently favored. Carcinoma in situ and lymphovascular invasion are important entities in recurrence and progression. According to the WHO guidelines, urothelial carcinoma’s morphological diversity is classified into 10 subtypes, and it is suggested to report the ratio of divergent differentiation and/or histological variants.

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Cited by 4 publications

References 6 publications

New Advances in the Prediction of NMIBC Recurrence by Genetic Biomarkers

New Advances in the Prediction of NMIBC Recurrence by Genetic Biomarkers

Atypical cells in urine sediment: a novel biomarker for early detection of bladder cancer

Pathological Staging, Grading, and Classifi Cation of Bladder Cancer

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