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Open Access 01-04-2008 | Original Article

Diagnostic algorithm for papillary urothelial tumors in the urinary bladder

Authors: Jung-Weon Shim, Kang Su Cho, Young-Deuk Choi, Yong-Wook Park, Dong-Wha Lee, Woon-Sup Han, Sang-In Shim, Hyun-Jung Kim, Nam Hoon Cho

Published in: Virchows Archiv | Issue 4/2008

Abstract

Papillary urothelial neoplasms with deceptively bland cytology cannot be easily classified. We aimed to design a new algorithm that could differentiate between these neoplasms based on a scoring system. We proposed a new scoring system that enables to reproducibly diagnose non-invasive papillary urothelial tumors. In this system, each lesion was given individual scores from 0 to 3 for mitosis and cellular thickness, from 0 to 2 for cellular atypia, and an additional score for papillary fusion. These scores were combined to form a summed score allowing the tumors to be ranked as follows: 0–1 = UP, 2–4 = low malignant potential (LMP), 5–7 = low-grade transitional cell carcinoma (TCC), and 8–9 = high-grade TCC. In addition to the scoring system, ancillary studies of MIB and p53 indexes with CK20 expression pattern analyses were compared together with clinical parameters. The MIB index was strongly correlated with disease progression. Four of the 22 LMP patients (18.2%) had late recurrences, two of these four (9.1%) had progression to low-grade carcinoma. The MIB index for LMP patients was strongly associated with recurrence (recurrence vs. non-recurrence, 16.5 vs. 8.1, p < 0.001). The proposed scoring system could enhance the reproducibility to distinguish papillary urothelial neoplasms.

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Title: Diagnostic algorithm for papillary urothelial tumors in the urinary bladder
Authors: Jung-Weon Shim
Kang Su Cho
Young-Deuk Choi
Yong-Wook Park
Dong-Wha Lee
Woon-Sup Han
Sang-In Shim
Hyun-Jung Kim
Nam Hoon Cho
Publication date: 01-04-2008
Publisher: Springer-Verlag
Published in: Virchows Archiv / Issue 4/2008
Print ISSN: 0945-6317
Electronic ISSN: 1432-2307
DOI: https://doi.org/10.1007/s00428-008-0585-x

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Diagnostic algorithm for papillary urothelial tumors in the urinary bladder

Abstract

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