Murat AKGÜL, Meltem ÖZNUR, Cenk Murat YAZICI, Enes ALTIN, Ayşegül İSAL ARSLAN

Yüksek Dereceli Kasa İnvaze Olmayan Mesane Tümörlerinde Histolojik Derecelendirme Oranının Progresyona Etkisi

KİOMT’de yüksek dereceli hücresel farklılaşma oranı ve diğer rutin patolojik parametrelerin progresyona etkisi değerlendirildi. Materyal ve Metot: Çalışmaya 2010-2018 yılları arasında transüretral mesane rezeksiyonu sonrası yüksek dereceli KİOMT tanısı alan 92 hasta dahil edildi. Hastaların demografik bilgileri, tümör çapı, lokalizasyonu, multisantrisitesi ve nüks/progresyon varlığı-süresi retrospektif olarak değerlendirildi. Ayrıca tümör hücrelerinin yüksek derece/düşük derece yüzdesi, tümör evresi, diferansiyasyon, nekroz, lamina propria invazyonu, lenfovasküler invazyon ve karsinoma in-situ varlığı iki üro-patolog tarafından incelendi. Elde edilen bulguların tümör progresyonu üzerine etkisi araştırıldı. Bulgular: Hastaların 74’ü(%80,4) T1, 18’i(%19,6) Ta olarak rapor edildi. Ta tanılı hastalarda yüksek derece oranı %11,9±8,5 iken, T1’lerde %69,5±28,1 olarak tespit edildi (p%25,>%50 ve>%75 olan hasta sayısının sırasıyla 67(%72,8), 54(%58,7) ve 43(%46,7) olduğu görüldü. Ta olan hastaların sadece 1’inde yüksek derece oranı>%25 olarak gözlenirken, T1 hastalarının 66’sında yüksek derece oranının>%25 olduğu belirlendi (p%75 olduğu görüldü. T1 yüksek derece oranları>%50 olan hastalarda progresyon, patolojik evresi T1 yüksek derece oranları %50 olan hastalarda progresyon anlamlı derecede artmaktadır.

THE EFFECTS OF HISTOLOGICAL GRADE RATIO ON THE PROGRESSION OF HIGH-GRADE NON-MUSCLE INVASIVE BLADDER TUMORS

Aim: Histopathological classification is one of the main prognostic factors for non-muscle invasive bladder tumors (NMIBT). Weevaluated the relationship between tumor progression and the ratio of high-grade differentiation plus other routine pathologicalparameters in NMIBT.Materials and Methods: Ninety-two patients diagnosed with high grade NIMBT were analyzed between 2010-2018. Demographicinformation, tumor size, localization, multicentricity, and recurrence/progression situation were evaluated retrospectively. The high/lowgrade percentage ratio of tumor cells, tumor stage, differentiation, necrosis, lamina-propria invasion, lymphovascular invasion, andcarcinoma in-situ presence were also examined by two uro-pathologist. The effect on tumor progression was evaluated with pathologicalfindings.Results: Seventy-four (80.4%) of the patients were reported as T1 and 18 (19.6%) as Ta. The mean ratio of high-grade findings was11.9±8.5% and 69.5±28.1% for Ta and T1 patients, respectively(p25%, >50% and >75% was found to be 67(72.8%),54(58.7%) and 43(46.7%), respectively. The high-grade ratio for >25% was in only 1 Ta patient while it was in 66 of the T1patients(p75%(p50%(p=0.025).Conclusion: When evaluating the nuclear grade, defining tumors solely as high-grade leads to stratifying a highly heterogeneouspopulation in a single group. Higher rate of progression is observed in NIMBT patients with high-grade ratio >50%.

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