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Urothelkarzinom der Harnblase

Kombinierte endoskopische und urinzytologische Beurteilung: Lässt es sich sicher einschätzen?

Urothelial carcinoma of the bladder

Evaluation by combined endoscopy and urine cytology: Is incontrovertible assessment possible?

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Zusammenfassung

Hintergrund

Die transurethrale Resektion von Tumoren der Harnblase dient der vollständigen Entfernung des Tumors, sowie der Entnahme von Gewebe zur histologischen Untersuchung. Nichtinvasive Low-grade-Tumoren mit geringem Progressionsrisiko sind durch eine oberflächliche Resektion ausreichend therapiert; um dies rechtfertigen zu können, muss eine sichere Unterscheidung zwischen nichtinvasiven Low-grade-, High-grade- und invasiven Tumoren möglich sein.

Material und Methode

Es wurden 160 Patienten mit zystoskopisch gesichertem Urothelkarzinom der Harnblase einer fraktionierten transurethralen Resektion unterzogen. Der Tumor wurde perioperativ makroskopisch und mittels bimanueller Palpation und Urinzytologie eingeschätzt und im Verlauf mit der definitiven Histologie verglichen.

Ergebnisse

In unserer Studie konnte sicher zwischen Low-grade- und High-grade-Tumoren unterschieden werden. Ebenso konnten alle nichtmuskelinvasiven Befunde makroskopisch auch als solche erkannt werden.

Schlussfolgerung

Der in der Urinzytologie erfahrene Urologe kann durch die intraoperative makroskopische Tumoreinschätzung in Verbindung mit der perioperativen Bewertung der Urinzytologie gut differenzierte nichtmuskelinvasive Urothelkarzinome der Harnblase sicher einschätzen.

Abstract

Background

Transurethral resection of transitional cell carcinoma of the bladder provides a definitive surgical treatment and supplies tissue for histological evaluation. Superficial low-grade carcinomas with a small risk of progression are treated properly with fulguration alone. To justify fulguration as a definitive treatment of papillary bladder tumours, one must be able to safely distinguish low-grade, noninvasive tumours from those that are high grade and potentially invasive.

Material and methods

A total of 160 patients with a transitional cell carcinoma at cystoscopy underwent transurethral resection of the tumour. The macroscopic appearance of the tumour, the aspect with bimanual palpation and the perioperative urine cytology were compared with the histological report.

Results

In our study we were able to safely distinguish low-grade tumours from high-grade tumours. All noninvasive tumours could be identified visually as such.

Conclusion

Urologists skilled in the evaluation of urine cytology can distinguish low-grade noninvasive tumours of the bladder from high-grade and potentially invasive tumours by means of appearance at cystoscopy and perioperative urine cytology.

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Literatur

  1. Cheng L, Neumann RM, Weaver AL et al (2000) Grading and staging bladder carcinoma in transurethral resection specimens: correlation with 105 matched cystectomy specimens. Am J Clin Pathol 113(2):275–279

    Article  PubMed  CAS  Google Scholar 

  2. Cina SJ, Epstein JI, Endrizzi JM et al (2001) Correlation of cystoscopic impression with histologic diagnosis of biopsy specimens of the bladder. Hum Pathol 32(6):630–637

    Article  PubMed  CAS  Google Scholar 

  3. Droller MJ (1998) Bladder cancer: state-of-the-art care. Cancer J Clin 48:269–284

    Article  CAS  Google Scholar 

  4. Francica G, Bellini SA, Scarano F et al (2008) Correlation of transabdominal sonographic and cystoscopic findings in the diagnosis of focal abnormalities of the urinary bladder wall: a prospective study. J Ultrasound Med 27(6):887–894

    PubMed  Google Scholar 

  5. Grimm D, Bauer J, Schoenberger J (2009) Blockade of neoangiogenesis, a new and promising technique to control the growth of malignant tumors and their metastases. Curr Vasc Pharmacol 7(3):347–357

    Article  PubMed  CAS  Google Scholar 

  6. Mian C, Lodde M, Comploj E et al (2005) The value of the ImmunoCyt/uCyt+ test in the detection and follow-up of carcinoma in situ of the urinary bladder. 15. Anticancer Res 25(5):3641–3644

    PubMed  Google Scholar 

  7. Niedworok C, Rembrink V, Hakenberg OW et al (2009) Stellenwert der Urinzytologie in der Diagnostik von High-grade-Urotheltumoren. Urologe A 48(9):1018–1024

    Article  PubMed  CAS  Google Scholar 

  8. Oosterlinck W, Lobel B, Jakse G et al (2002) Guidelines on bladder cancer. Eur Urol 41:105–112

    Article  PubMed  Google Scholar 

  9. Raica M, Miclea F, Ioiart I et al (1998) Urin cytology in the follow-up of patients with transitional cell carcinoma of the urinary bladder: is that enough as a single method? Rom J Morphol Embryol 44(1–4):173–178

    Google Scholar 

  10. Rathert (2003) Urinzytologie beim Harnblasenkarzinom. Kritische Wertung. Urologe A 42:908–911

    Article  PubMed  CAS  Google Scholar 

  11. Riesz P, Lotz G, Paska C et al (2007) Detection of bladder cancer from the urin using fluroescence in situ hybridization technique. Pathol Oncol Res 13(3):187–194

    Article  PubMed  Google Scholar 

  12. RUTT (Registry for urinary tract tumours) (1985) Harnwegstumorregister, Jahresbericht. Verh Dtsch Ges Urol 37:665

    Google Scholar 

  13. Stonehill WH, Goldman HB, Dmochowski RR (1997) The use of urin cytology for diagnosing bladder cancer in spinal cord injured patients. J Urol 157(6):2112–2114

    Article  PubMed  CAS  Google Scholar 

  14. Talwar R, Sinha T, Karan SC et al (2007) Voided urinary cytology in bladder cancer: is it time to review the indications? Urology 70:267–271

    Article  PubMed  Google Scholar 

  15. Tritschler S, Sommer ML, Straub J et al (2010) Urinary cytology in era of flurorescence endoscopy: redefining the role of an established method with a new reference standard. World J Urol 28(2):169–172

    Article  Google Scholar 

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Authors and Affiliations

  1. Klinik für Urologie, Kinderurologie und Urologische Onkologie, Universitätsklinikum Essen, Hufelandstraße 55, 45122, Essen, Deutschland

    J. Hess, S. Tschirdewahn, T. Szarvas, R. Rossi, H. Rübben &  F. vom Dorp

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  1. J. Hess
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  2. S. Tschirdewahn
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  3. T. Szarvas
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  4. R. Rossi
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  5. H. Rübben
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  6. F. vom Dorp
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Correspondence to F. vom Dorp.

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Hess, J., Tschirdewahn, S., Szarvas, T. et al. Urothelkarzinom der Harnblase. Urologe 50, 702–705 (2011). https://doi.org/10.1007/s00120-010-2502-6

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