Ayşenur KELEŞ, İpek GÖNÜL IŞIK, Uğur FIRAT, Mehmet KÜÇÜKÖNER

Mesanenin ürotelyal karsinomları üzerine epidemiyolojik bir çalışma

Bu çalışmada mesane ürotelyal kanserlerinin, bilinen çevresel faktörler eşliğinde epidemiyolojik analizinin yapılması amaçlanmıştır. Gereç ve yöntem: Retrospektif olan bu çalışmaya 350’si erkek (%83.4), 70’i kadın (%16,6) hasta olmak üzere toplam 420 hastaya ait mesane transüretral rezeksiyon, sistektomi ve sistoprostatektomi patoloji arşiv materyallerinde; histopatolojik olarak ürotelyal karsinom ve düşük malign potansiyelli papiller ürotelyal neoplazi tanısı almış vakalar dahil edildi. Tümör tipi, yaş-cinsiyet, invaziv-noninvaziv gibi parametrelere ait veriler değerlendirilerek istatistiksel analizleri yapıldı. Bulgular: Bu çalışmada düşük malign potansiyele sahip papiller ürotelyal neoplazi %24.7, düşük dereceli ürotelyal karsinom %46.1 ve yüksek dereceli ürotelyal karsinom %29.0 oranlarında bulundu. Mesane ürotelyal karsinomlarının erkeklerde kadınlara göre 5 kat daha fazla görüldüğü saptandı. Ayrıca, yüksek dereceli papiller ürotelyal karsinomun kadınlara kıyasla daha çok erkeklerde (sırasıyla %23,1 ve %31,2), düşük dereceli papiller ürotelyal karsinomun ise erkeklere kıyasla daha çok kadınlarda (sırasıyla %18,5 ve %32,9) görüldüğü saptandı. Sonuç: Çalışma sonucunda, mesane ürotelyal karsinomlarının erkeklerde kadınlara göre daha fazla görüldüğü ve ayrıca lamina propria ve muskularis propria invazyonu gösteren yüksek dereceli ürotelyal karsinomların da yine erkek cinsiyette daha yüksek oranda bulunduğu tesbit edildi. Bu tümörlerin, özellikle de yüksek dereceli olan tiplerinin neden erkek cinsiyette daha sık görüldüğüne ilişkin kapsamlı klinik ve deneysel çalışmalara ihtiyaç vardır.

An epidemiologic study on urothelial carcinomas of bladder

In this study, the epidemiological analysis of the bladder cancers was performed accompanied by the known environmental factors. Materials and methods: In this retrospective study, pathology archival materials of 420 patients (350 men (83.4%) and 70 women (16.6%)), consisting of bladder by transurethral resection, cystectomy and cystoprostatectomy specimens, histopathologically diagnosed as urothelial carcinoma and papillary urothelial neoplasia with low malignant potential, were included. For bladder carcinomas, the parameters such as tumor types, age, sex, and invasiveness of tumor were evaluated and analyzed. Results: In the study, it was found that 24.7% of papillary urothelial neoplasia with low malignant potential, 46.1% of low-grade urothelial carcinoma, and 29.0% of high grade urothelial carcinoma. The rate of bladder urothelial carcinomas was 5 times greater in men than in women. In addition, the high-grade papillary urothelial carcinoma was seen more frequently in men than in women (31.2% and 23.1% respectively), while low-grade papillary urothelial carcinoma was seen more frequently in women than in men (32.9% and 18.5% respectively) (p<0.05). Conclusion: The bladder urothelial carcinoma was more common in men than women, and high-grade urothelial carcinoma invading the lamina propria and the muscularis propria also found in a higher ratio in male. Further clinical and experimental studies are needed to explore the cause of high frequency of high-grade types in male gender.

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1. Eble JN, Sauter G, Epstein JI et al. Pahology and Genetics of Tumors of the Urinary System and Male Genital Organs. Tumors of the urinary system. IARC Pres, Lyon 2004:89- 120.
2. Horstmann M, Witthuhn R, Falk M, Stenzl A. Gender-specific differences in bladder cancer: a retrospective analysis. Gen Med 2008;5(4):385-94.
3. Delclos GL, Lerner SP. Occupational risk factors. Scand J Urol Nephrol 2008;42(218):58-63.
4. Janković S, Radosavljević V. Risk factors for bladder cancer. Tumor 2007;93(1):4-12.
5. Malats N. Genetic epidemiology of bladder cancer: scaling up in the identification of low-penetrance genetic markers of bladder cancer risk and progression. Scand J Urol Nephrol 2008;42(218):131-40.
6. Nilsson S, Ullen A. Chemotherapy-induced bladder cancer. Scand J Urol Nephrol 2008;42(218):89-92.
7. Mills SE, Carter D, Greenson JK, Oberman HA, Reuter V, Stoler MH. Urinary tract and male genital system. Sternberg’s Diagnostic Surgical Pathology, Volume 3. 4th ed. Baltimore, Buenos Aires, Hong Kong, London, New York, Philadelphia, Sydney, Tokyo. Lippincott Williams&Wilkins 2004:2035-82.
8. Rosai J. Urinary tract. Rosai and Ackerman’s Surgical Pathology, Volume 1. 9th ed. Edinburgh, London, New York, Oxford, Philadelphia, St Louis, Sydney, Toronto. Mosby 2004:1317-1360.
9. Bermejo JL, Sundquist J, Hemminki K. Sex-spesific familial risks of urinary bladder cancer and associated neoplasms in Sweeden. Int J Cancer 2009;124(9):2166-71.
10. Scosyrev E, Noyes K, Feng C, Messing E. Sex and racial differences in bladder cancer presentation and mortality in the US. Cancer 2009;115(1):68-74.
11. Boffetta P. Tobacco smoking and risk of bladder cancer. Scand J Urol Nephrol 2008;42(218):45-54.
12. Fleshner N, Garland J, Moadel A, Herr H, Ostroff J, Trambert R, O’Sullivan M, Russo P. Influence of smoking status on the disease-related outcomes of patients with tobaccoassociated superficial transitional cell carcinoma of the bladder. Cancer 1999;86(11):2337-45.
13. Mitra AP, Cote RJ. Molecular pathogenesis and diagnostics o bladder cancer. Annu Rev Pathol 2009;4:251-85.
14. Parkin DM. The global burden of urinary bladder cancer. Scand J Urol Nephrol 2008;42(218):12-20.
15. Wu X, Ros MM, Gu J, Kiemeney L. Epidemiology and genetic susceptibility to bladder cancer. BJU Int 2008;102(9):1207-15.
16. Pelucchi C, Tavani A, La Vecchia C. Coffee and alcohol consumption and bladder cancer. Scand J Urol Nephrol Suppl 2008;42(218):37-44.
17. Bircan S, Candır Ö, Kapucuoglu N. The effect of tumor invasion patterns on pathologic stage of bladder urothelial carcinomas. Pathol Oncol Res 2005;11(2):87-91.
18. Narayana AS, Loening SA, Slymen DJ, Culp DA. Bladder cancer: factors affecting survival. J Urol 1983;130(1):56- 60.