膀胱癌の病理組織学的検討一生検標本と全摘除術施行全層標本との比較

Abstract

We studied the ratio of agreement between biopsy specimens and all-layer specimens in regard to growth pattern, histological classification, staging, grading, lymphatic invasion, intravenous invasion and infiltrating type of 42 cases in which it was possible to make a comparison among radical cystectomy cases treated between November 1976 and October 1988. The above 7 categories were studied according to the General Rule for Clinical and Pathological Studies on Bladder Cancer (Japanese Urological Association and Japanese Pathological Society). The result showed that the ratio of agreement between the biopsy specimens and the all-layer specimens was 90.5% according to growth pattern. The ratio of agreement was 85.7% according to histological classification but 76.2% according to staging. When grading was not based on the lower grade of cells occupying the major portion, but the higher grade of cells occupying the minor portion the ratio of agreement was 88.1%. The ratio of agreement was 76.2% according to lymphatic invasion. However, when lymphatic invasion was seen on the all-layer specimens, the ratio of agreement was 74.4% according to lymphatic invasion. The ratio of agreement was 76.2% according to intravenous invasion. However, when intravenous invasion was seen on the all-layer specimens, the ratio of agreement was 58.3% according to intravenous invasion. The ratio of agreement was 76.8% in regard to infiltrating type. Staging, grading, and vascular invasion are important prognostic factors in bladder cancer. According to our study, biopsy specimens alone are not enough to evaluate the staging and the presence of vascular invasion. For more accurate diagnosis, we must resect deep and multiple biopsy specimens.