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2000, Volume 16, Number 3-4, Page(s) 106-112
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RECLASSIFICATION OF NONINVASIVE PAPILLARY UROTHELIAL NEOPLASMS ACCORDING TO THE WHO/ISUP CONSENSUS CLASSIFICATION AND EVALUATION OF p53 AND Ki 67 OVEREXPRESSION IN THESE SUBGROUPS
Zehra GÜLÇİFTÇİ, Ayşenur AKYILDIZ İĞDEM, Pınar TUZLALI, Ruhi SARI, Can ARAT, Nusret ERDOĞAN
Taksim Eğitim ve Araştırma Hastanesi Patoloji Bölümü, Taksim Eğitim ve Araştırma Hastanesi Üroloji Servisi
Abstract
Objective: In 1998 WHO/ISUP consensus meeting, stage pTa urothelial cell neoplasms of the bladder were classified under the term “non-invasive papillary urothelial neoplasms” and four histomorphologic subgroups were defined. This study evaluate whether p53 and Ki-67 overexpression in these subgroups may be of value in estimating recurrences and prognosis.

Materials and Methods: A retrospective review was made of 50 cases who were diagnosed papilloma, grade-II (Mostofi) and stage pTa urothelial cell carcinoma between 1995-99 in Taksim State Hospital. All cases were classified into four subgroups according to the concensus. Samples were stained immunohistochemically for p53 and Ki-67 and correlation was sought between overexpression of p53 and Ki-67 and prognosis.

Results: 95% of the bladder carcinomas diagnosed in our laboratory were of ürothelial cell origin and 32% of these were in stage pTa and papilloma grade I-II (Mostofi). 15% of the cases were urothelial papilloma (UP), 33% papillary urothelial neoplasm with low malignant potential (PUN-LMP), 29% low-grade papillary urothelial carcinoma (LG-PUC) and 23% high-grade papillary urothelial carcinoma (HG-PUC). Mean expression levels of p53 and Ki-67 were 0.03 and 0.0380 in urothelial papilloma, 0.0660and 0.080 in papillary urothelial neoplasm with low malignant potential, 0.1999 and 0.1969 in low-grade and 0.3517 and 0.3010 in high-grade papillary urothelial carcinoma, respectively.

Conclusion: The study results were consistent with WHO/ISUP concensus classification with respect to recurrence and progression of papillary urothelial neoplasms, with p53 and Ki-67 overexpression levels being compatible with the diagnosis of the subgroups.

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