Reproducibility of the 1998 World Health Organization/International Society of Urologic Pathology Classification of Papillary Urothelial Neoplasms of the Urinary Bladder

Overview

Journal Virchows Arch

Specialties Cell Biology
Molecular Biology
Pathology

Date 2003 Oct 10

PMID 14534785

Citations 18

Authors

Kutsal Yorukoglu

Burcin Tuna

Emel Dikicioglu

Ender Duzcan

Aydin Isisag

Sait Sen

Ugur Mungan

Ziya Kirkali

Affiliations

Soon will be listed here.

Abstract

Objectives: This study assessed the diagnostic agreement and intra- and inter-observer reproducibility of the World Health Organization/International Society of Urologic Pathology Consensus Classification of Urothelial Neoplasms (1998 WHO/ISUP classification) and the 1973 WHO classification.

Methods: A teaching set with 5 slides of each papillary neoplasm of low malignant potential, low-grade papillary carcinoma, high-grade papillary carcinoma, and a guideline, as well as a study set of 30 slides containing ten cases of each category, were sent to participants. Six pathologists expert in urological pathology reviewed the 30 slides of non-invasive papillary urothelial tumors in the study set. Diagnostic accuracy and reproducibility were evaluated using intra- and inter-rater techniques (kappa statistic).

Results: A moderate to substantial intra- and inter-observer reproducibility was achieved for both the 1998 WHO/ISUP and 1973 WHO classification. The results of the two classification systems were not different statistically ( P>0.05). Reproducibility was lower in low-grade tumors for both classifications.

Conclusions: The new proposed classification system for non-invasive urothelial neoplasms does not increase the reproducibility. There is still a need for uniformity in grading in order to compare the different studies and therapies and to provide more accurate information for management.

Citing Articles

Recent Advances in the Classification of Bladder Cancer - Updates from the 5th Edition of the World Health Organization Classification of the Urinary and Male Genital Tumors.

Guo C, Shen S, Czerniak B Bladder Cancer. 2024; 9(1):1-14.

PMID: 38994481 PMC: 11181758. DOI: 10.3233/BLC-220106.

Bladder cancer prognosis using deep neural networks and histopathology images.

Barrios W, Abdollahi B, Goyal M, Song Q, Suriawinata M, Richards R J Pathol Inform. 2022; 13:100135.

PMID: 36268091 PMC: 9577122. DOI: 10.1016/j.jpi.2022.100135.

Urinary exosomal microRNA-96-5p and microRNA-183-5p expression as potential biomarkers of bladder cancer.

El-Shal A, Shalaby S, Abouhashem S, Elbary E, Azazy S, Rashad N Mol Biol Rep. 2021; 48(5):4361-4371.

PMID: 34085193 DOI: 10.1007/s11033-021-06451-5.

A Machine Learning Approach for Long-Term Prognosis of Bladder Cancer based on Clinical and Molecular Features.

Song Q, Seigne J, Schned A, Kelsey K, Karagas M, Hassanpour S AMIA Jt Summits Transl Sci Proc. 2020; 2020:607-616.

PMID: 32477683 PMC: 7233061.

Assessment of Histopathological Parameters Useful in the Diagnosis of Low Grade Non-Invasive Urothelial Carcinomas.

Sandulescu A, Stepan A, Margaritescu C, Crisan A, Simionescu C Curr Health Sci J. 2020; 45(4):383-389.

PMID: 32110440 PMC: 7014981. DOI: 10.12865/CHSJ.45.04.06.

References

Cheng L, NEUMANN R, Weaver A, Cheville J, Leibovich B, Ramnani D . Grading and staging of bladder carcinoma in transurethral resection specimens. Correlation with 105 matched cystectomy specimens. Am J Clin Pathol. 2000; 113(2):275-9. DOI: 10.1309/94B6-8VFB-MN9J-1NF5. View

Pich A, Chiusa L, Formiconi A, Galliano D, Bortolin P, Navone R . Biologic differences between noninvasive papillary urothelial neoplasms of low malignant potential and low-grade (grade 1) papillary carcinomas of the bladder. Am J Surg Pathol. 2001; 25(12):1528-33. DOI: 10.1097/00000478-200112000-00009. View

Oosterhuis J, Schapers R, Janssen-Heijnen M, Pauwels R, Newling D, Ten Kate F . Histological grading of papillary urothelial carcinoma of the bladder: prognostic value of the 1998 WHO/ISUP classification system and comparison with conventional grading systems. J Clin Pathol. 2002; 55(12):900-5. PMC: 1769816. DOI: 10.1136/jcp.55.12.900. View

Epstein J, Amin M, Reuter V, Mostofi F . The World Health Organization/International Society of Urological Pathology consensus classification of urothelial (transitional cell) neoplasms of the urinary bladder. Bladder Consensus Conference Committee. Am J Surg Pathol. 1998; 22(12):1435-48. DOI: 10.1097/00000478-199812000-00001. View

Allsbrook Jr W, Mangold K, Johnson M, LANE R, LANE C, Epstein J . Interobserver reproducibility of Gleason grading of prostatic carcinoma: general pathologist. Hum Pathol. 2001; 32(1):81-8. DOI: 10.1053/hupa.2001.21135. View

Sorensen F, Sasaki M, Fukuzawa S, Yamabe H, Olsen S, Yoshida O . Qualitative and quantitative histopathology in transitional cell carcinomas of the urinary bladder. An international investigation of intra- and interobserver reproducibility. Lab Invest. 1994; 70(2):242-54. View

Oyasu R . World Health Organization and International Society of Urological Pathology classification and two-number grading system of bladder tumors. Cancer. 2000; 88(7):1509-12. DOI: 10.1002/(sici)1097-0142(20000401)88:7<1509::aid-cncr1>3.0.co;2-g. View

Wells W, Carney P, Eliassen M, Grove M, Tosteson A . Pathologists' agreement with experts and reproducibility of breast ductal carcinoma-in-situ classification schemes. Am J Surg Pathol. 2000; 24(5):651-9. DOI: 10.1097/00000478-200005000-00003. View

Cheng L, NEUMANN R, Nehra A, Spotts B, Weaver A, Bostwick D . Cancer heterogeneity and its biologic implications in the grading of urothelial carcinoma. Cancer. 2000; 88(7):1663-70. DOI: 10.1002/(sici)1097-0142(20000401)88:7<1663::aid-cncr21>3.0.co;2-8. View

10.

Holmang S, Hedelin H, Anderstrom C, Johansson S . The relationship among multiple recurrences, progression and prognosis of patients with stages Ta and T1 transitional cell cancer of the bladder followed for at least 20 years. J Urol. 1995; 153(6):1823-6; discussion 1826-7. View

11.

Carbin B, Ekman P, Gustafson H, Christensen N, Sandstedt B, Silfversward C . Grading of human urothelial carcinoma based on nuclear atypia and mitotic frequency. I. Histological description. J Urol. 1991; 145(5):968-71. DOI: 10.1016/s0022-5347(17)38502-6. View

12.

Bostwick D, Mikuz G . Urothelial papillary (exophytic) neoplasms. Virchows Arch. 2002; 441(2):109-16. DOI: 10.1007/s00428-002-0624-y. View

13.

Ooms E, Anderson W, Alons C, Boon M, Veldhuizen R . Analysis of the performance of pathologists in the grading of bladder tumors. Hum Pathol. 1983; 14(2):140-3. DOI: 10.1016/s0046-8177(83)80242-1. View

14.

Lipponen P, Simpanen H, Pesonen E, Eskelinen M, Sotarauta M, Collan Y . Potential of morphometry in grading transitional cell carcinoma of the urinary bladder. Pathol Res Pract. 1989; 185(5):617-20. DOI: 10.1016/S0344-0338(89)80205-5. View

15.

Alsheikh A, Mohamedali Z, Jones E, Masterson J, Gilks C . Comparison of the WHO/ISUP classification and cytokeratin 20 expression in predicting the behavior of low-grade papillary urothelial tumors. World/Health Organization/Internattional Society of Urologic Pathology. Mod Pathol. 2001; 14(4):267-72. DOI: 10.1038/modpathol.3880300. View

16.

Holman C, James I, Heenan P, MATZ L, BLACKWELL J, Kelsall G . An improved method of analysis of observer variation between pathologists. Histopathology. 1982; 6(5):581-9. DOI: 10.1111/j.1365-2559.1982.tb02752.x. View

17.

Cheng L, NEUMANN R, Bostwick D . Papillary urothelial neoplasms of low malignant potential. Clinical and biologic implications. Cancer. 1999; 86(10):2102-8. View

18.

Kakizoe T, Tobisu K, Mizutani T, Tsutsumi M, Tanaka Y, Sakamoto M . Analysis by step sectioning of early invasive bladder cancer with special reference to G3.pT1 disease. Jpn J Cancer Res. 1992; 83(12):1354-8. PMC: 5918733. DOI: 10.1111/j.1349-7006.1992.tb02769.x. View

19.

Blomjous C, Smeulders A, Baak J, Vos W, van Galen C, Meijer C . A comparative study in morphometric grading of transitional cell carcinoma of the urinary bladder. Anal Quant Cytol Histol. 1989; 11(6):426-32. View

20.

Desai S, Lim S, Jimenez R, Chun T, Keane T, McKenney J . Relationship of cytokeratin 20 and CD44 protein expression with WHO/ISUP grade in pTa and pT1 papillary urothelial neoplasia. Mod Pathol. 2001; 13(12):1315-23. DOI: 10.1038/modpathol.3880241. View