中华泌尿外科杂志
中華泌尿外科雜誌
중화비뇨외과잡지
CHINESE JOURNAL OF UROLOGY
2010年
2期
104-106
,共3页
陈俊星%黄斌%陈凌武%丘少鹏%李晓飞%陈炜%戴宇平%梁月有%王道虎%陈羽%吴荣佩%车丽红
陳俊星%黃斌%陳凌武%丘少鵬%李曉飛%陳煒%戴宇平%樑月有%王道虎%陳羽%吳榮珮%車麗紅
진준성%황빈%진릉무%구소붕%리효비%진위%대우평%량월유%왕도호%진우%오영패%차려홍
膀胱肿瘤%病理分级%临床应用
膀胱腫瘤%病理分級%臨床應用
방광종류%병리분급%림상응용
Bladder neoplasms%Pathological grading%Clinical application
目的 比较非浸润性膀胱尿路上皮癌WHO 2004年和1973年病理分级方法的临床应用价值.方法 采用WHO 2004和1973 2种病理分级方法对160例非浸润性膀胱尿路上皮癌患者进行病理分级,随访患者复发和进展情况,比较分析2种分级系统临床应用差异. 结果 160例患者按1973分级方法:乳头状瘤5例,尿路上皮癌G_1 52例、G_2 83例、G_3 20例;按2004分级法:乳头状瘤7例,低度恶性潜能尿路上皮乳头状瘤(PUNLMP)31例、低分级尿路上皮乳头状癌(LGPUC)99例、高分级尿路上皮乳头状癌(HGPUC)23例.1973分级法各级别间复发与进展情况差异均无统计学意义(P>0.05);2004分级法各级别间复发差异无统计学意义(P>0.05),进展情况差异有统计学意义(P<0.05),其中PUNLMP与HGPUC差异有统计学意义(P<0.01).2004分级法HGPUC级别进展率(30.4%)明显高于1973分级法G_3级别进展率(15.0%). 结论 WHO 2004分级法中HGPUC级别衍含更多的高度恶性尿路上皮细胞癌,较1973分级法G_3级别更容易发生进展,临床上对HGPUC级别患者应采用更严密的治疗和随访措施.
目的 比較非浸潤性膀胱尿路上皮癌WHO 2004年和1973年病理分級方法的臨床應用價值.方法 採用WHO 2004和1973 2種病理分級方法對160例非浸潤性膀胱尿路上皮癌患者進行病理分級,隨訪患者複髮和進展情況,比較分析2種分級繫統臨床應用差異. 結果 160例患者按1973分級方法:乳頭狀瘤5例,尿路上皮癌G_1 52例、G_2 83例、G_3 20例;按2004分級法:乳頭狀瘤7例,低度噁性潛能尿路上皮乳頭狀瘤(PUNLMP)31例、低分級尿路上皮乳頭狀癌(LGPUC)99例、高分級尿路上皮乳頭狀癌(HGPUC)23例.1973分級法各級彆間複髮與進展情況差異均無統計學意義(P>0.05);2004分級法各級彆間複髮差異無統計學意義(P>0.05),進展情況差異有統計學意義(P<0.05),其中PUNLMP與HGPUC差異有統計學意義(P<0.01).2004分級法HGPUC級彆進展率(30.4%)明顯高于1973分級法G_3級彆進展率(15.0%). 結論 WHO 2004分級法中HGPUC級彆衍含更多的高度噁性尿路上皮細胞癌,較1973分級法G_3級彆更容易髮生進展,臨床上對HGPUC級彆患者應採用更嚴密的治療和隨訪措施.
목적 비교비침윤성방광뇨로상피암WHO 2004년화1973년병리분급방법적림상응용개치.방법 채용WHO 2004화1973 2충병리분급방법대160례비침윤성방광뇨로상피암환자진행병리분급,수방환자복발화진전정황,비교분석2충분급계통림상응용차이. 결과 160례환자안1973분급방법:유두상류5례,뇨로상피암G_1 52례、G_2 83례、G_3 20례;안2004분급법:유두상류7례,저도악성잠능뇨로상피유두상류(PUNLMP)31례、저분급뇨로상피유두상암(LGPUC)99례、고분급뇨로상피유두상암(HGPUC)23례.1973분급법각급별간복발여진전정황차이균무통계학의의(P>0.05);2004분급법각급별간복발차이무통계학의의(P>0.05),진전정황차이유통계학의의(P<0.05),기중PUNLMP여HGPUC차이유통계학의의(P<0.01).2004분급법HGPUC급별진전솔(30.4%)명현고우1973분급법G_3급별진전솔(15.0%). 결론 WHO 2004분급법중HGPUC급별연함경다적고도악성뇨로상피세포암,교1973분급법G_3급별경용역발생진전,림상상대HGPUC급별환자응채용경엄밀적치료화수방조시.
Objective To compare WHO 2004 and WHO 1973 pathological grading methods of non-muscle invasive urothelial neoplasms. Methods The clinical pathological features of 160 non-muscle invasive urothelial neoplasms patients, treated in our hospital from February, 1998 to Decem-ber, 2008, were re-graded according to WHO 2004 and WHO 1973 classification system. To evaluate recurrence and progression of all the patients during the follow up period, we used statistical method to analyses the differences between two classification system. Results There were 160 patients, ac-cording to WHO 1973 classification methods: 5 cases of papilloma, 52 cases of grade 1 tumors, 83 ca-ses of grade 2 and 20 cases of grade 3;By WHO 2004 classification method: 7 cases of papilloma, 31 cases of low-grade malignant potential of urothelial papilloma, 99 cases of low-grade papillary urotheli-al carcinoma and 23 cases of high-grade papillary urothelial carcinoma. There was no difference in re-currence among the grades of WHO 2004 and WHO 1973 pathological grading system (both P>0.05). Regarding the progress of non-muscle invasive papillary urothelial neoplasms, no significant difference was found among grades of WHO 1973 classification system(P>0.05)while difference exis-ted among grades of WHO 2004 pathological grading system (P<0.05), especially between papillary neoplasm of low malignant potential (PNLMP) and high grade papillary urothelial carcinomas(HG-PUC) (P<0.01). Moreover, HGPUC grade had more progression rate (30.4%) than G_3 grade (15.0%). Conclusions Compare to G_3 grade, HGPUC grade was more easily to make progress in pa-tients,due to this grade include more high malignant papillary urothelial carcinomas. Therefore, it is necessary for urologists to use a more rigorously follow up and therapy method in connection with HG-PUC grade of new classification system.
