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pT1 high-grade bladder cancer: histologic criteria, pitfalls in the assessment of invasion, and substaging.
Virchows Archiv ( IF 3.4 ) Pub Date : 2020-04-15 , DOI: 10.1007/s00428-020-02808-6
Maria Rosaria Raspollini 1 , Rodolfo Montironi 2 , Roberta Mazzucchelli 2 , Alessia Cimadamore 2 , Liang Cheng 3 , Antonio Lopez-Beltran 4, 5
Affiliation  

Most patients with bladder carcinoma are diagnosed with non-muscle-invasive disease, stage Ta, and pT1. Stage remains as the single most important prognostic indicator in urothelial carcinoma. Among the pT1 bladder cancer patients, recurrence and progression of disease occur in 50% and 10%, respectively. The identification of high-risk patients within the pT1 subgroup remains an important clinical goal and an active field of research. Substaging of pT1 disease has been claimed as important histologic discriminator by the 2016 World Health Organization (WHO) classification of the genitourinary tract tumors and by the 8th edition of the American Joint Committee on Cancer (AJCC) staging manual supporting its implementation in clinical practice. Interobserver variation in pT1 diagnosis and the associated pitfalls in pT1 assessment are the critical pathological issues. The aim of this review paper is to provide the practicing pathologist with the state of the art of morphological and immunohistochemical features useful for the diagnosis of early invasive bladder carcinomas, including practical clues on how to avoid relevant interpretative pitfalls, and to summarize the current status of pT1 substaging.

中文翻译:

pT1高度膀胱癌:组织学标准,评估浸润程度和分类的陷阱。

大多数患有膀胱癌的患者被诊断出患有非肌肉浸润性疾病,Ta期和pT1。分期仍然是尿路上皮癌最重要的单一预后指标。在pT1膀胱癌患者中,疾病的复发和进展分别发生在50%和10%。鉴定pT1亚组内的高危患者仍然是重要的临床目标和活跃的研究领域。pT1疾病的替代被2016年世界卫生组织(WHO)的泌尿生殖道肿瘤分类和美国癌症联合委员会(AJCC)第8版分期手册声称是重要的组织学鉴别剂,支持其在临床实践中的实施。pT1诊断中观察者间的差异以及pT1评估中的相关陷阱是关键的病理问题。本文的目的是为病理医生提供对形态学和免疫组织化学特征的最新研究,这些特征可用于诊断早期浸润性膀胱癌,包括有关如何避免相关解释性陷阱的实用线索,并总结当前的状况pT1子集。
更新日期:2020-04-22
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