Stage Progression in Ta Papillary Urothelial Tumors: Relationship to Grade, Immunohistochemical Expression of Tumor Markers, Mitotic Frequency and Dna Ploidy

Abstract

The 1988 WHO and International Society of Urological Pathology consensus classifications divide noninvasive papillary bladder tumors into 3 subgroups with different clinical behavior, which seems to be an advantage compared with the 1973 WHO classification. A disadvantage is that the high grade carcinoma group contains 2 subgroups with different progression rates and immunohistochemical marker profiles, corresponding to the 1999 WHO grades 2 and 3. Grade 2 tumors in patients that progressed in stage years later seem to have different immunohistochemical and molecular marker profiles compared to those in matched controls.

Histological classification and stage of newly diagnosed bladder cancer in a population-based study from the Northeastern United States

“…The two studies with population-based design (the current study and that of Holmäng et al [28]) show very similar grade distribution results. The two hospital-or clinic-based studies [21,27], in contrast, show considerable variation.…”

“…to arsenic, but this requires further investigation. It is conceivable, although unlikely, that the similarity of the results to those of Holmäng et al [14,28] from Scandinavia could in part be related to similar ethnic mix, levels of industrialization, lifestyle or other demographic characteristics, rather than to the population-based character of the study population. Future analyses to evaluate potential histological patterns associated with exposure history may provide helpful etiological clues.…”

“…Table V presents a comparison of the WHO (1973) grading system between hospital-and clinic-based [21,27] and population-based [28] studies. The two studies with population-based design (the current study and that of Holmäng et al [28]) show very similar grade distribution results.…”

“…The published diagnostic criteria of the WHO/ISUP classification system, however, have been profusely illustrated and described in unusual detail; this was done expressly to reduce diagnostic variability and subjectivity [18,19]. Also, the similarity of the data to those of other studies with a populationbased design [14,23,28] suggests similar application of diagnostic criteria. In addition, internal checks for intraobserver variability supported the intrastudy stability of diagnoses.…”

Gene expression profiling of noninvasive primary urothelial tumours using microarrays

“…Patients diagnosed with bladder cancer often get recurrent tumours. Tumour recurrence develops in 35% of patients with papillary urothelial neoplasm of low malignant potential (PUNLMP), in 71% of patients with low-grade urothelial carcinoma, and in 73% of patients with high-grade carcinoma (Holmang et al, 2001). Ta tumours are superficial papillary neoplasms that do not invade the submucosa and muscle layers of the bladder.…”