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Stereological estimates of nuclear volume in the prognostic evaluation of primary flat carcinoma in situ of the urinary bladder
Author(s) -
SØRENSEN F.B.,
JACOBSEN F.
Publication year - 1991
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/j.1365-2559.1991.tb01480.x
Subject(s) - urothelium , carcinoma in situ , biopsy , carcinoma , medicine , urinary bladder , pathology , stage (stratigraphy) , nuclear medicine , urology , biology , paleontology
Primary, flat carcinoma in situ of the urinary bladder is rare and its behaviour is unpredictable. The aim of this retrospective study was to obtain base‐line data and investigate the prognostic value of unbiased, stereological estimates of the volume‐weighted mean nuclear volume, nuclear V v , in 78 bladder biopsies from 22 patients with primary flat carcinoma in situ (Bergkvist grades III‐IV). On average, nuclear V v was 77 μm 3 in nine biopsies with morphologically normal urothelium, 292 μm 3 in 56 isolated primary lesions and 266 μm 3 in lesions of luminal urothelium in 13 biopsies with co‐existing invasive carcinoma. No recognizable developmental pattern of nuclear V v in relation to the time course of disease was found. Nuclear volume in the first biopsy was of the same magnitude in lesions with and without co‐existing invasive carcinoma (2 P =0.55), and in lesions with short and long duration of invasion‐free period (2 P < 0.20). Nuclear V v in the first biopsy did not differ between patients who survived and those who died from their primary flat carcinoma in situ (2 P =0.07). Dividing the patients on the basis of the group median of the first biopsy showing flat carcinoma in situ (nuclear V v = 261 μm 3 ), the survival was the same in patients with nuclear V v above and below the cut‐off point (2 P =0.16). However, the survival curves showed a tendency to differ in the first 2‐8 years of observation. Stereological estimates of nuclear V v provide objective, quantitative information, but their prognostic value in patients with primary flat carcinoma in situ of the bladder needs further clarification in larger data bases.