Clinical and morphological features of inflammatory, precancerous, and cancerous lesions of the urothelium

Abstract

Introduction. Bladder cancer (BC) is a significant public health problem due to its high likelihood of relapse and local or metastatic progression, which requires big government funding. The study of the urothelial precancerous lesions contributes to the earlier disease detection and influences the management strategy. However, experts argue on how to interpret pathological processes of the urothelium, therefore, the purpose of our study was to evaluate clinical and morphological features of inflammatory, precancerous, and cancerous lesions of the urothelium. Materials and methods. The study included 120 patients (77 men and 43 women) with inflammatory, pre-cancerous, and cancerous lesions of the urothelium. The patients were divided into 4 subgroups: subgroup I included 11 patients with reactive atypia of the urothelium; subgroup II involved 24 patients with urothelial dysplasia; subgroup III consisted of 51 patients with non–muscle-invasive BC (NMIBC); and subgroup IV included 34 patients with muscle-invasive BC (MIBC). We assessed clinically gender, age, size, lesion location, singleness and multiplicity of lesions, and the presence of blood in the urine. We also performed pathological assessment for subgroups III and IV: we studied the level of tumor invasion and the tumor grade. For statistical processing of the data, we used IBM SPSS Statistics (version 23) for Windows. Results. The study revealed tumor lesions to be more common in men than in women. The size of urothelial dysplasia in women was significantly greater than in men (U=26; p=0.019). In subgroup III (NMIBC), multiple lesions were more common with increasing age (U=155.5; p=0.048). In subgroup IV (MIBC), younger patients were found to have less differentiated tumors. Conclusion. This study demonstrated the clinical and morphological features of patients with inflammatory, precancerous, and cancerous lesions of the bladder. Keywords: bladder cancer, muscle non-invasive bladder cancer, muscle invasive bladder cancer, urothelial dysplasia, reactive atypia, oncology, pathology