Author/Editor		Ovčak, Zdenka
Title		Klasifikacija urotelnih tumorjev sečnega mehurja WHO/ISUP
Translated title		WHO/ISUP classification of the urothelial tumors of the urinary bladder
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 74, št. 9
Publication year		2005
Volume		str. 529-33
Language		slo
Abstract		Background. The authors present the current classification of urothelial neoplasms of the urinary bladder. The classification of urothelial tumors of the urinary bladder of 1973 was despite some imperfection relatively successfuly used for more than thirty years. The three grade classification of papillary urothelial tumors without invasion has been based on evaluation of variations in architecture of covering epithelium and tumor cell anaplasia. As reccomended by the International Society of Urological Pathologists (ISUP), the World Health Organisation (WHO) accepted the new WH0/ ISUP classification in 1998 that was revised in 2002 and finally published in 2004. With intention to avoid unnecessary diagnosis of cancer in patients having papillary urothelial tumors with rare invasive or metastastatic growth, this classification introduced a new entity, the papillary urothelial neoplasia of low malignant potential (PUNLMP). The additional change in classification was the division of invasive urothelial neoplasms only to low and high grade urothelial carcinomas. Conclusions. The authors' opinion is that although the old classification is not recommended for use any more the new one is not solving the elementary reproaches to previous classification such as terminological unsuitability and insufficient scientific reasoning. Our proposed solution in classification of papillary urothelial neoplasms would be the application of criteria analogous to that used in diagnostics of papillary non invasive tumors of the head and neck or alimentary tract.
Summary		Izhodišča. V članku avtorji predstavijo najnovejšo razdelitev urotelnih tumorjev sečnega mehurja, ki je dokončno stopila v veljavo leta 2002. Klasifikacija urotelnih tumorjev sečnega mehurja iz leta 1973, ki je temeljila na tristopenjski razvrstitvi papilarnih urotelnih tumorjev brez invazijske rašče, se je kljub pomanjkljivostim dokaj uspešno uporabljala skoraj 30 let. Temeljila je na oceni motenj citoarhitektonike krovnega urotela in stopnji anaplazije tumorskih celic Na predlog Mednarodrzega združenja uroloških patologov (ISUP) je Svetovna zdravstvena organizacija (WHO) leta 1998 sprejela novo klasifikacijo WHO/ISUP, ki je za razliko od stare uvedla novo entiteto »papilarno urotelno neoplazijo nizkega malignega potenciala". Nameravali so se izogniti neugodni diagnozi karcinoma pri papilarnih urotelnih tumorjih, ki izredno redko izkazujejo invazijsko rast in zasevanje. Poleg tega je nova klasifikacija razdelila invazivne urotelne karcinome sečnega mehurja samo na kurcinome nizke (low grade) in visoke (high grade) stopnje rnalignosti. Zaključki. Avtorji menijo, da nova klasifikacija, ki so jo sicer dolžni uporabljati, ne rešuje osnovnih protislovij in pomanjkljivosti stare klasifikacije, da je terminološko neustrezna in tudi znanstveno ne dovolj utemeljena. Izhod iz nastalega položaja vidijo v aplikaciji analognih meril, ki veljajo pri diagnostiki papilarnih neinvazivnih tumorjev grla in prebavil.
Descriptors		BLADDER NEOPLASMS UROTHELIUM HYPERPLASIA PAPILLOMA CARCINOMA