Bladder Mucosal Pathological Changes Accompany High Grade and Squamous Cell Bladder Tumors | ||
| Iraqi Postgraduate Medical Journal | ||
| Article 1, Volume 9, Issue 4, December 2010, Pages 536-541 PDF (0 K) | ||
| Author | ||
| Jassim Mohammad Alkhazraji | ||
| Abstract | ||
| ABSTRACT: BACKGROUND: Carcinoma of the bladder is the second most common cancer in Iraq. The status of the bladder urothelium other than the principal lesions can provide distinct diagnostic information with regard to treatment response and outcome. Positive mucosal biopsy results are a significant indicator of intravesical recurrence. Currently, in our urological practice, the importance of performing this step in cystoscopy is relatively underestimated. OBJECTIVE: The objective of this study is to carry out a histological assessment of 'extra-tumor' bladder mucosa for dysplasia, and correlate the resulting findings of dysplasia with the grade, the type, and the macroscopic appearance of the tumor. MATERIALS AND METHODS: A total of 350 biopsies were taken by cystoscopy from 68 patients admitted with bladder tumors, either by cold-cupped biopsy forceps or resectoscope as part of TUR of the tumor. Normal-looking mucosa of the bladder was included in each patient's biopsy in a four quadrant way. All biopsies were examined by the same histopathologist. All patients were managed according to their presentation, cystoscopic and histopathological findings. RESULTS: Statistical analysis showed that the highest significant difference was obtained in patients with tumor grade, low against high grade (p<0.005). However, a noticeable difference was found in the other two comparison groups, namely, the type, transitional against squamous and the macroscopic appearance, papillary against solid (p<0.05). CONCLUSION: The high grade, solid tumors and squamous cell carcinoma are associated with general bladder mucosal dysplastic changes which may exclude the bladder preserving procedures as an option of surgical treatment. In Iraq, more extensive studies are necessary to come out with appropriate guidelines for a better treatment and outcome of bladder carcinoma which is a major health problem. | ||
| Keywords | ||
| bladder carcinoma; cystoscopy; dysplasia; histopathology; TCC; SCC | ||
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