BACKGROUND Intracytoplasmic lumina (ICL) are observed in several cancers, including urothelial carcinoma (UC). We have reported that ICL in urine cytology (cICL) is more frequent in high-grade UCs than in low-grade UCs; however, the correlation between the presence of ICL and prognosis is unclear. OBJECTIVES The aim of this work was to determine the association between cICL and prognosis in bladder cancer. METHOD We retrospectively investigated 87 patients with bladder cancer who received a histological diagnosis within 3 months of urine cytology at Kanazawa Medical University between 2003 and 2007. The cytological diagnosis and the number of cICL, histological diagnosis, tumor grade or variant, pT stage, ICL in histological specimens, and immunohistochemistry for mucins were evaluated. Data on the treatment type, recurrence, survival, cause of death, and length of follow-up were collected from electronic medical records. RESULTS Muscle invasion, high-grade UC, lymph node metastasis, distant metastasis, adjuvant therapy, and disease-related mortality were more frequent in patients with cICL-positive bladder cancer than in those without cICL-positive bladder cancer. Immunohistochemistry revealed the expression of Muc-1 and Muc-4 in patients with cICL-positive bladder cancer. Univariate analysis revealed that cytological diagnosis by the Paris system and the 2015 version of the Japanese reporting system, muscle invasion, high-grade UC, lymph node metastasis, distant metastasis, and adjuvant chemotherapy and/or radiotherapy were significant factors associated with prognosis. Furthermore, survival was shorter in patients with cICL-positive non-muscle-invasive bladder cancer than in those with cICL-negative non-muscle-invasive bladder cancer. In the multivariate analysis, only distant metastasis was significantly associated with survival. CONCLUSIONS cICL predicted shorter survival in patients with non-muscle-invasive bladder cancer, suggesting that ICL is one of the important diagnostic features of high-grade UC with a worse prognosis in urine cytology.

中文翻译：

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尿液细胞学中的胞浆内腔可预测非肌肉浸润性膀胱癌的预后。

背景技术在包括尿路上皮癌（UC）在内的几种癌症中观察到了胞浆内腔（ICL）。我们已经报道，在尿液细胞学检查中，ICL在高级别UC中比在低级别UC中更为频繁。然而，ICL的存在与预后之间的相关性尚不清楚。目的这项研究的目的是确定cICL与膀胱癌预后之间的关系。方法我们回顾性调查了2003年至2007年间在金泽医科大学进行尿细胞学检查的3个月内接受组织学诊断的87例膀胱癌患者。细胞学诊断和cICL数量，组织学诊断，肿瘤分级或变异，pT分期，ICL在组织学标本中，对粘蛋白的免疫组织化学进行了评估。有关治疗类型，复发，生存率，从电子病历中收集死亡原因和随访时间。结果与没有cICL阳性膀胱癌的患者相比，cICL阳性膀胱癌患者的肌肉浸润，高级别UC，淋巴结转移，远处转移，辅助治疗和疾病相关的死亡率更高。免疫组织化学揭示了cICL阳性膀胱癌患者中Muc-1和Muc-4的表达。单因素分析显示，巴黎系统和2015年版日本报告系统的细胞学诊断，肌肉浸润，高级UC，淋巴结转移，远处转移以及辅助化疗和/或放疗是与预后相关的重要因素。此外，cICL阳性的非肌肉浸润性膀胱癌患者的生存期短于cICL阴性的非肌肉浸润性膀胱癌患者。在多变量分析中，只有远处转移与生存率显着相关。结论cICL预测非肌肉浸润性膀胱癌患者的生存期较短，提示ICL是高级别UC的重要诊断特征之一，尿细胞学预后较差。