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Zhang W, Zhang Z, Xiao W, Wang Y, Ye L, Wei Y, Luo M. Multiple directional DWI combined with T2WI in predicting muscle layer and Ki-67 correlation in bladder cancer in 3.0-T MRI. Cancer Med 2023; 12:10462-10472. [PMID: 36916547 DOI: 10.1002/cam4.5782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 02/17/2023] [Accepted: 02/25/2023] [Indexed: 03/16/2023] Open
Abstract
OBJECTIVE To investigate the value of 3.0T MRI multi-directional diffusion-weighted imaging (DWI) combined with T2WI morphological features and lesion distribution in preoperative prediction of muscle layer invasion of bladder cancer (BC) and the correlation with postoperative Ki-67. MATERIALS AND METHODS This retrospective study enrolled patients with BC between 2019 and 2021. Patients with muscular invasive bladder cancer (MIBC) or non-muscular invasive BC (NMIBC) were also analyzed by preoperative 3.0T MRI aFostic efficacy. RESULTS A total of 186 patients were enrolled. About 27 patients with MIBC (35 lesions in total) and 62 with NMIBC (99 lesions in total). We found the tumor with a larger size, a wide base, and a smaller apparent dispersion coefficient (ADC) value and normalized ADC(nADC) value, without a stalk, presenting a greater risk of muscle invasion. ADC value, nADC value, maximum diameter, and stalk were independently associated with muscle invasion. Lesions located at the bladder fundus or involvement of multiple sites were independently associated with muscle invasion compared to the bladder body. In combination with morphological features, the AUCs of ADC and nADC showed accuracies of 0.925 and 0.947-0.951, respectively. TADC and nTADC showed the best diagnostic efficacy in multiple respects. KI-67 LI was negatively correlated with ADC and nADC values. CONCLUSIONS This is the first report in which we found Multi-directional DWI combined with T2WI in 3.0T MRI can be used to predict the muscle layer invasion of bladder cancer. ADC values reflect the muscular invasion of bladder cancer and show a moderate negative correlation with Ki-67. It is especially suitable for bladder cancer patients with renal insufficiency or tumor recurrence.
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Affiliation(s)
- Wei Zhang
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China.,Department of Radiology, Fujian Provincial Hospital, Fuzhou, China
| | - Zhichao Zhang
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China.,Department of Radiology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, China
| | - Weixiong Xiao
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China.,Department of Radiology, Fujian Provincial Hospital, Fuzhou, China
| | - Yiqian Wang
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China.,Department of Radiology, Fujian Provincial Hospital, Fuzhou, China
| | - Liefu Ye
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China.,Department of Urology, Fujian Provincial Hospital, Fuzhou, China
| | - Yongbao Wei
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China.,Department of Urology, Fujian Provincial Hospital, Fuzhou, China
| | - Min Luo
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China.,Department of Radiology, Fujian Provincial Hospital, Fuzhou, China
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2
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Taylor C, Puzyrenko A, Iczkowski KA. Trends in disagreement with outside genitourinary pathology diagnoses at an academic center. Pathol Res Pract 2022; 236:153997. [PMID: 35780705 DOI: 10.1016/j.prp.2022.153997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 06/27/2022] [Indexed: 10/17/2022]
Abstract
AIMS To evaluate the frequencies and types of disagreements in a contemporary urological second-opinion consult service in order to improve pathologist awareness. METHODS For 7 years ending 30 October 2021, records were kept of our department's total urologic outside consultation and disagreed-upon cases. Disagreements were categorized according to specimen type and nature of conflict. All grading and staging assignments used International Society of Urological Pathology (ISUP) criteria. Statistical analyses for each specimen type included the percent disagreement. Cohen's kappa analysis was done to measure interrater reliability on the prostate biopsies, prostatectomies, and the bladder biopsies/resections. In addition, for the prostate biopsies, the potential for change in treatment candidacy calculation (CTC), was assessed as sum of changes from cancer to non-malignant tissue or the reverse, plus changes from Gleason Grade group (GG)1 to GG ≥ 2 (3 +4 =7) or the reverse. RESULTS Overall mean disagreement rate for all specimens was 15.2%. The highest rate was among 1545 prostate biopsy cases, where 410 contained disagreements (26.5%). 118 (7.6%) met criteria for CTC: 10 cases were altered from cancer to non-cancer, 38 cases downgraded from GG≥ 2 to GG1, and 70 upgraded from GG1 to GG≥ 2. Second opinion downgraded the overall highest GG more often than it upgraded it, with downgrade:upgrade ratios of 64:37 for the GG1/GG2 threshold, 79:67 for the GG2/GG3, and 14:0 for the GG3/GG4. 146 specimen parts had disagreements as to cancer vs. suspicious vs. benign, with 85 undercalled and 61 overcalled. Other rates of disagreement included: prostatectomy 34/198 (17.2%); bladder resection or biopsy 68/591 (11.5%); kidney 27/175 (15.4%); and orchiectomy 9/82 (11.0%). In bladder specimens, overgrading was 6X more frequent than undergrading; and overstaging muscularis propria invasion was 6X more frequent than understaging. CONCLUSIONS The review of uropathologic materials before definitive therapy can lead to changes that impact clinical decisions significantly. As an example, for prostate biopsies, candidacy for active surveillance versus definitive treatment hinges on GG1 versus 2 and this distinction constituted most CTC cases. The above findings highlight aspects of urological pathology to be emphasized to residents in training, and pathologists in practice.
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Affiliation(s)
- Carley Taylor
- Department of Pathology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Andrii Puzyrenko
- Department of Pathology, Medical College of Wisconsin, Milwaukee, WI, USA
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3
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Wenger K, Tirdad K, Dela Cruz A, Mari A, Mayada Basheer, Kuk C, van Rhijn BW, Zlotta AR, van der Kwast TH, Sadeghian A. A semi-supervised learning approach for bladder cancer grading. MACHINE LEARNING WITH APPLICATIONS 2022. [DOI: 10.1016/j.mlwa.2022.100347] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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4
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Liedberg F, Kjellström S, Lind AK, Sherif A, Söderkvist K, Falkman K, Thulin H, Aljabery F, Papantonio D, Ströck V, Öfverholm E, Jerlström T, Sandzen J, Verbiene I, Ullén A. Swedish National Guidelines on Urothelial Carcinoma: 2021 update on non-muscle invasive bladder cancer and upper tract urothelial carcinoma. Scand J Urol 2022; 56:137-146. [DOI: 10.1080/21681805.2022.2041086] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Fredrik Liedberg
- Department of Urology, Skåne University Hospital, Malmö, Sweden
- Department of Translational Medicine, Lund University, Malmö, Sweden
| | | | - Anna-Karin Lind
- Department of Urology, Skåne University Hospital, Malmö, Sweden
- Department of Translational Medicine, Lund University, Malmö, Sweden
| | - Amir Sherif
- Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden
| | | | - Karin Falkman
- Department of Urology, Södersjukhuset, Stockholm, Sweden
| | - Helena Thulin
- Genitourinary Oncology and Urology Unit, CLINTEC, Karolinska Institutet and Department of Pelvic Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - Firas Aljabery
- Division of Urology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | | | - Viveka Ströck
- Department of Urology, Sahlgrenska University Hospital and Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
| | | | - Tomas Jerlström
- Department of Urology, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Johan Sandzen
- Department of Oncology, Karlstad County Hospital, Karlstad, Sweden
| | - Ingrida Verbiene
- Department of Oncology, Uppsala Akademiska Hospital, Uppsala, Sweden
| | - Anders Ullén
- Genitourinary Oncology and Urology Unit, Department of Oncology-Pathology, Karolinska Institutet and Department of Pelvic Cancer, Karolinska University Hospital, Stockholm, Sweden
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5
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Anatomic pathology quality assurance: Developing an LIS based tracking and documentation module for intradepartmental consultations. J Pathol Inform 2022; 13:100109. [PMID: 36268096 PMCID: PMC9577041 DOI: 10.1016/j.jpi.2022.100109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 05/27/2022] [Accepted: 05/31/2022] [Indexed: 11/20/2022] Open
Abstract
Background An electronic intradepartmental consultation system for anatomic pathology (AP) was conceived and developed in the laboratory information system (LIS) in 2019. Previously, all surgical pathology intradepartmental consultative activities were initiated and documented with paper forms which circulated with the pertinent microscopic slides and were eventually filed. In this study, we discuss the implementation and utilization of an electronic intradepartmental AP consultation system. Methods Workflows and procedures were developed to organize intradepartmental surgical pathology consultations from the beginning to the end point of the consultative activities entirely using a paperless system that resided in the LIS. Results The electronic consult system allowed electronic documentation of all steps of intradepartmental consultative activities. The system provided tracking ability for consulted cases and improved access to consult discussion for all departmental personnel, staff, and trainees. Consultation work queue was created for each pathologist and a summary of individual consultative workload was possible. Documentation of anatomic pathology quality assurance for intradepartmental consultative activity was easily assessed. Conclusions The electronic intradepartmental consult system has allowed our department to electronically track intradepartmental consult cases, store the consultative opinion text with the case, record the pathologists involved, and document the consultation for internal quality assurance review as well as for accrediting organizations. Summarization of pathologist workload related to consultative activity was quantifiable and optimization of the consultative process was maximized for education in an academic setting.
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6
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Chang CH, Wu WJ, Lee HY, Lin CH, Yue CT, Jiang YH, Lee YK, Huang KH, Tsai YC. Impact of Pathology Review in Adverse Histological Characteristics and pT Stages of Upper Tract Urothelial Cancer in a Multicenter Study. Front Oncol 2021; 11:757359. [PMID: 34900706 PMCID: PMC8655678 DOI: 10.3389/fonc.2021.757359] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 10/25/2021] [Indexed: 01/18/2023] Open
Abstract
Purpose Pathology reviews for upper urinary tract cancer (UTUC) remained scarce in the literature. Here, we reported the interobserver variation among the review and local pathologies of featured histologic characteristics for UTUC. Methods Patients who underwent definitive surgical treatments for UTUC were retrospectively reviewed for eligibility of pathology review. In the Taiwan UTUC Collaboration cohort, 212 cases were reviewed, of which 154 cases were eligible for pathology review. Agreement between original pathology and review pathology was measured by the total percentage of agreement and by simple kappa statistics. The prognostic impact was analyzed by the Cox regression model with the estimation of hazard ratios (HR) and 95% confidence intervals. Results There were 80 women and 74 men enrolled in this study, and the median age at treatment was 71.7 years. The agreement is moderate agreement for surgical margin status (87.7%; κ = 0.61), tumor grade (82.5%; κ = 0.43), tumor invasiveness (76.6%; κ = 0.45), lymphovascular invasion (70.8%; κ = 0.42) and T stage (67.5%; κ = 0.52). The interobserver agreements for perineural invasion and variant histology identification were slight. Kaplan–Meier analysis for disease-free survival revealed comparable results in local and review pathology for localized (Tis, Ta, T1–2) or advanced T stage (T3–4). Conclusions Pathology review of UTUC had minimal impact on clinical practice based on current available disease treatment guidelines. However, significant interobserver variations were observed in featured adverse histopathological characters.
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Affiliation(s)
- Chia-Hui Chang
- Division of Endocrine and Metabolism, Department of Internal Medicine, Taipei Tzu Chi Hospital, The Buddhist Medical Foundation, New Taipei City, Taiwan
| | - Wen-Jeng Wu
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hsiang-Ying Lee
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chih-Hung Lin
- Department of Pathology, Kaohsiung Municipal Hsiaokang Hospital, Kaohsiung, Taiwan.,Department of Pathology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chung-Tai Yue
- Department of Anatomic Pathology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Yuan-Hong Jiang
- Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan
| | - Yu-Khun Lee
- Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan
| | - Kuan Hsun Huang
- Division of Urology, Department of Surgery, Dalin Tzuchi Hospital, The Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
| | - Yao Chou Tsai
- Department of Urology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Urology, Taipei Medical University Hospital, Taipei Medical University, Taipei City, Taiwan.,TMU Research Center of Urology and Kidney (TMU-RCUK), Taipei Medical University, Taipei, Taiwan
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7
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Hoffman-Censits JH, Lombardo KA, Parimi V, Kamanda S, Choi W, Hahn NM, McConkey DJ, McGuire BM, Bivalacqua TJ, Kates M, Matoso A. Expression of Nectin-4 in Bladder Urothelial Carcinoma, in Morphologic Variants, and Nonurothelial Histotypes. Appl Immunohistochem Mol Morphol 2021; 29:619-625. [PMID: 33901032 PMCID: PMC8429050 DOI: 10.1097/pai.0000000000000938] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 03/23/2021] [Indexed: 11/26/2022]
Abstract
The antibody-drug conjugate enfortumab-vedotin acts by targeting nectin-4, a protein that is nearly ubiquitously expressed in conventional urothelial cancer. However, expression of nectin-4 in morphologic variants of urothelial carcinoma and nonurothelial histotypes was unknown. Immunohistochemistry for nectin-4 using was performed on 169 patients including 83 with nonmuscle invasive bladder cancer and 86 patients with muscle invasive bladder cancer. Staining was scored for intensity (0 to 3) and extent (% positive cells) using the histological score system, where >15 was considered positive. Overall, 72/83 (87%) samples of nonmuscle invasive urothelial carcinoma were positive, including 29/30 (97%) noninvasive papillary urothelial carcinomas, 7/8 (87.5%) carcinomas in situ, 36/45 (80%) papillary urothelial carcinomas invading the lamina propria. Overall, 50/86 muscle invasive tumors were positive, including 15/22 (68.2%) urothelial carcinomas, 7/10 (70%) squamous cell carcinomas, 3/11 (28%) micropapillary tumors, 4/6 (66%) adenocarcinomas, 2/4 (50%) nested carcinomas, 5/8 (63%) plasmacytoid, 1/10 (10%) sarcomatoid carcinomas, and 0/15 (0%) small cell carcinomas. Whole transcriptome RNA sequencing revealed that compared with conventional urothelial carcinomas, most sarcomatoid carcinomas and all but 2 small cell carcinomas expressed very low levels of nectin-4 mRNA but expressed significant levels of either trop2 or ERBB2, which are the molecular targets of 2 other antibody-drug conjugates-sacituzumab gavitecan (trop2) or trastuzumab deruxtecan (ERBB2/HER2). In summary, our study demonstrates that there is heterogeneity of expression of nectin-4 in morphologic variants of urothelial cancer and nonurothelial histotypes, and suggests that testing expression of nectin-4 should be considered in morphologic variants or nonurothelial histotypes found to have lower expression.
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Affiliation(s)
- Jean H. Hoffman-Censits
- Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Oncolocy, Johns Hopkins University School of Medicine, Baltimore, MD
- Johns Hopkins Greenberg Bladder Cancer Institute
| | - Kara A. Lombardo
- Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD
- Johns Hopkins Greenberg Bladder Cancer Institute
| | - Vamsi Parimi
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Sonia Kamanda
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Woonyoung Choi
- Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD
- Johns Hopkins Greenberg Bladder Cancer Institute
| | - Noah M. Hahn
- Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Oncolocy, Johns Hopkins University School of Medicine, Baltimore, MD
- Johns Hopkins Greenberg Bladder Cancer Institute
| | - David J. McConkey
- Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Oncolocy, Johns Hopkins University School of Medicine, Baltimore, MD
- Johns Hopkins Greenberg Bladder Cancer Institute
| | - Bridget M. McGuire
- Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Trinity J. Bivalacqua
- Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Oncolocy, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Max Kates
- Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Oncolocy, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Andres Matoso
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Oncolocy, Johns Hopkins University School of Medicine, Baltimore, MD
- Johns Hopkins Greenberg Bladder Cancer Institute
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8
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Yanagisawa T, Yorozu T, Miki J, Iwatani K, Obayashi K, Sato S, Kimura T, Takahashi H, Egawa S. Feasibility and accuracy of pathological diagnosis in en-bloc transurethral resection specimens versus conventional transurethral resection specimens of bladder tumour: evaluation with pT1 substaging by 10 pathologists. Histopathology 2021; 78:943-950. [PMID: 33245791 DOI: 10.1111/his.14307] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 11/22/2020] [Indexed: 12/13/2022]
Abstract
AIMS En-bloc transurethral resection (TUR) of bladder tumour (ERBT) is designed to provide more accurate pathological diagnosis of specimens than conventional TUR of bladder tumour (cTURBT). Some studies have reported that T1 bladder cancer substage could be a prognostic factor in assessing tumour progression, but such substaging has not been widely adopted because of problems with pathological diagnosis using cTURBT specimens. The aim of this study was to evaluate the possible advantages of en-bloc TUR specimens in T1 substaging following assessment by a panel of 10 pathologists. METHODS AND RESULTS We assessed the substages in 123 patients (cTURBT, n = 91; ERBT, n = 32) who were diagnosed with pT1 bladder cancer. We randomly selected 10 ERBT specimens and 10 cTURBT specimens with cancer invasion areas equivalent to those of their corresponding ERBT specimens. Ten pathologists performed pT1 substaging for pT1a/b/c and pT1m/e in 20 patients (cTURBT, n = 10; ERBT, n = 10). We evaluated diagnostic times and rates of diagnostic concordance among these pathologists, comparing cTURBT and ERBT. The median diagnostic times per slide were 87.7 s [interquartile range (IQR) 71.9-109.2 s) for cTURBT and 54.7 s (IQR 46.0-59.6 s) for ERBT (P = 0.009). The rate of diagnostic concordance was significantly better for ERBT specimens. For pT1a/b/c, the median concordance rates were 50% for cTURBT and 80% for ERBT (P = 0.02); for pT1m/e, the median concordance rates were 70% for cTURBT and 90% for ERBT (P = 0.05). For pT1a/b/c, the average κ-values between the pathologist and the standard diagnosis were 0.04 for cTURBT and 0.47 for ERBT. CONCLUSIONS The use of ERBT specimens shortened the diagnostic time and minimised interobserver variability for T1 substaging compared with the use of cTURBT specimens.
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Affiliation(s)
- Takafumi Yanagisawa
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Takashi Yorozu
- Department of Pathology, The Kyorin University School of Medicine, Tokyo, Japan
| | - Jun Miki
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Kosuke Iwatani
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Koki Obayashi
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Shun Sato
- Department of Pathology, The Jikei University School of Medicine, Tokyo, Japan
| | - Takahiro Kimura
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Hiroyuki Takahashi
- Department of Pathology, The Jikei University School of Medicine, Tokyo, Japan
| | - Shin Egawa
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
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9
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Regmi SK, Konety BR. Variant Histology: Management Pearls. Bladder Cancer 2021. [DOI: 10.1007/978-3-030-70646-3_27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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10
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The Role of Imaging in Bladder Cancer Diagnosis and Staging. Diagnostics (Basel) 2020; 10:diagnostics10090703. [PMID: 32948089 PMCID: PMC7555625 DOI: 10.3390/diagnostics10090703] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/02/2020] [Accepted: 09/10/2020] [Indexed: 01/23/2023] Open
Abstract
Bladder cancer (BC) is the most common cancer of the urinary tract in the United States. Imaging plays a significant role in the management of patients with BC, including the locoregional staging and evaluation for distant metastatic disease, which cannot be assessed at the time of cystoscopy and biopsy/resection. We aim to review the current role of cross-sectional and molecular imaging modalities for the staging and restaging of BC and the potential advantages and limitations of each imaging modality. CT is the most widely available and frequently utilized imaging modality for BC and demonstrates good performance for the detection of nodal and visceral metastatic disease. MRI offers potential value for the locoregional staging and evaluation of muscular invasion of BC, which is critically important for prognostication and treatment decision-making. FDG-PET/MRI is a novel hybrid imaging modality combining the advantages of both MRI and FDG-PET/CT in a single-setting comprehensive staging examination and may represent the future of BC imaging evaluation.
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11
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Afferi L, Zamboni S, Baumeister P, Mordasini L, Mattei A, Moschini M. Adjuvant chemotherapy in bladder cancer patients with histological variants: time to change the approach? Transl Androl Urol 2019; 8:S280-S282. [PMID: 31392145 DOI: 10.21037/tau.2019.04.05] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Affiliation(s)
- Luca Afferi
- Klinik für Urologie, Luzerner Kantonsspital, Lucerne, Switzerland
| | - Stefania Zamboni
- Klinik für Urologie, Luzerner Kantonsspital, Lucerne, Switzerland
| | | | - Livio Mordasini
- Klinik für Urologie, Luzerner Kantonsspital, Lucerne, Switzerland
| | - Agostino Mattei
- Klinik für Urologie, Luzerner Kantonsspital, Lucerne, Switzerland
| | - Marco Moschini
- Klinik für Urologie, Luzerner Kantonsspital, Lucerne, Switzerland
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12
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Benbassat J. Obtaining a second opinion is a neglected source of health care inequalities. Isr J Health Policy Res 2019; 8:12. [PMID: 30651143 PMCID: PMC6335699 DOI: 10.1186/s13584-019-0289-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Accepted: 01/10/2019] [Indexed: 11/25/2022] Open
Abstract
Observational studies have detected discrepancies between two expert interpreters of imaging and histopathological studies. Furthermore, in a substantial proportion of patients, an independent second opinion disagreed with the first one. Therefore, it is widely accepted that patients have a right to obtain a second opinion and, in case of divergent opinions, to deliberate and choose the option that they believe is most consistent with their individual circumstances. However, doctors are less likely to inform old and poorly educated patients about the possibility of seeking a second opinion, and this may contribute to healthcare inequalities. Hence the importance of (a) promoting doctors’ self-awareness of a possible tendency to discriminate against old and poorly educated patients, and (b) creating programs within the healthcare system that would help patients in seeking a second opinion, suggest specialists for the specific problem of the patient, and provide tools to reconcile between discrepant opinions.
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Affiliation(s)
- Jochanan Benbassat
- Myers-JDC-Brookdale Institute, Department of Health Policy Research, PO Box 3886, 91037, Jerusalem, Israel.
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13
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Abstract
Bladder cancer has been identified as one of the most malignant cancers with high incidence and mortality. The underlying mechanisms by which regulate the tumorigenesis of bladder cancer deserve further investigation. Here, we found that miR-192-5p was downregulated in human bladder cancer cell lines and tissues. Overexpression of miR-192-5p significantly inhibited the growth of bladder cancer cells, while depletion of miR-192-5p exerted opposite effect. Bioinformatics analysis and molecular mechanism study identified that miR-192-5p targeted the transcription factor Yin Yang 1 (YY1) and decreased the expression level of YY1. Highly expressed YY1 attenuated the potential tumor suppressive function of miR-192-5p. The expression of miR-192-5p was negatively correlated with that of YY1 in bladder cancer tissues. These results indicated that miR-192-5p might serve as a promising target in bladder cancer diagnosis and therapy.
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