open access

Vol 9, No 5 (2004)
Published online: 2004-01-01
Submitted: 2004-02-19
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Histological classifications of tumours of the urinary bladder

Radzisław Kordek
DOI: 10.1016/S1507-1367(04)71025-1
·
Rep Pract Oncol Radiother 2004;9(5):173-177.

open access

Vol 9, No 5 (2004)
Published online: 2004-01-01
Submitted: 2004-02-19

Abstract

There are several classifications of tumours of the urinary bladder still being used: the WHO classification of 1973, the WHO classification of 1999, the “Scandinavian” system, the “American” system. These classifications use different names and different criteria, which cause important problems in communication. The WHO classifications published in 1999, was supposed to clarify these problems, but it was not widely accepted both by clinicians and pathologists. Especially urologists did not accept such a wide scale of tumours, with a new entity: PUNLMP (papillary urothelial neoplasm of low malignant potential). From the clinical point of view, the most important information is the clinical stage and histological grade but only on a dual scale: high grade (G2/3) or low grade (PUNLMP, papilloma, carcinoma G1). These differences between histological classifications and clinicians need to be clarified.

Molecular studies provide important information for histological and clinical classifications of the bladder tumors. Mutations of FGFR3 (fibroblast growth factor receptor 3 gene) often occur in low grade and early stage tumours, whereas they are very rare in high grade or advanced cancers. Moreover, FGFR3 mutation seems to be a better prognostic factor than histological grade and stage. Thus, FGFR3 mutations may be regarded as a “marker” of benign tumours, and as recently reported alternative genetic pathway for P53 mutations, which occur in more malignant tumours. From these studies, it seems possible that a majority of high grade, advanced tumours growth “de novo”, not on the basis of previous low grade tumour.

Abstract

There are several classifications of tumours of the urinary bladder still being used: the WHO classification of 1973, the WHO classification of 1999, the “Scandinavian” system, the “American” system. These classifications use different names and different criteria, which cause important problems in communication. The WHO classifications published in 1999, was supposed to clarify these problems, but it was not widely accepted both by clinicians and pathologists. Especially urologists did not accept such a wide scale of tumours, with a new entity: PUNLMP (papillary urothelial neoplasm of low malignant potential). From the clinical point of view, the most important information is the clinical stage and histological grade but only on a dual scale: high grade (G2/3) or low grade (PUNLMP, papilloma, carcinoma G1). These differences between histological classifications and clinicians need to be clarified.

Molecular studies provide important information for histological and clinical classifications of the bladder tumors. Mutations of FGFR3 (fibroblast growth factor receptor 3 gene) often occur in low grade and early stage tumours, whereas they are very rare in high grade or advanced cancers. Moreover, FGFR3 mutation seems to be a better prognostic factor than histological grade and stage. Thus, FGFR3 mutations may be regarded as a “marker” of benign tumours, and as recently reported alternative genetic pathway for P53 mutations, which occur in more malignant tumours. From these studies, it seems possible that a majority of high grade, advanced tumours growth “de novo”, not on the basis of previous low grade tumour.

Get Citation

Keywords

urinary bladder; classification; urothelial carcinoma; papillary carcinoma

About this article
Title

Histological classifications of tumours of the urinary bladder

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 9, No 5 (2004)

Pages

173-177

Published online

2004-01-01

DOI

10.1016/S1507-1367(04)71025-1

Bibliographic record

Rep Pract Oncol Radiother 2004;9(5):173-177.

Keywords

urinary bladder
classification
urothelial carcinoma
papillary carcinoma

Authors

Radzisław Kordek

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