【摘要】 目的探讨膀胱癌术前膀胱镜活检低估病理分级现象的可能原因,为治疗方案选择提供更可靠的依据。方法采用WHO/ISUP 1998病理分级标准,对82例术前膀胱镜活检诊断为膀胱癌、术后病理检查资料完整的患者分级情况进行对比分析。结果82例术前活检标本病理分级为G₁ 35例、G₂ 28例、G₃ 19例,术后标本为G₁ 22例、G₂ 32例、G₃ 28例。活检标本与术后标本病理分级一致54例（65．8%）,活检低分级24例（29．3%）,高分级4例（4．9%）。低估原因可能与活检钳取部位、组织量以及病理判断上的保守等相关。结论膀胱癌术前活检病理分级较术后低估比例达29．3%,在决定膀胱癌治疗方案时,应充分重视膀胱镜活检存在病理分级低估现象。更多还原

【Abstract】 Objective To compare the histologic grade between biopsy and postoperative specimen in bladder urothelial carcinoma,and approach the state and the reasons of underestimate the histologic grade preoperative.Methods We retrospectively 82 cases of urothelial carcinoma at the Third Affiliated Hospi- tal of the Sun Yat-Sen University.For all the cases in this study,the histologic grade,using the 1998 World Health Organization and International Society of Urological Pathologists（WHO/ISUP）classification,was i- dentical when the biopsy specimen and postoperative specimen were compared.Results In this study,35 cases,28 cases and 19 cases were G₁、G₂、G₃ by biopsy preoperative,respectively;while 22 cases,32 cases、28 cases were G₁、G₂、G₃ postoperative,respectively.There were 24 cases（29.3%）underestimate the histo- logic grade by biopsy preoperative in the 82 cases,while 4 cases（4.9%）overestimate preoperative.The state of underestimate the histologic grade is correlated with the location of biopsy,tissue dose and the conser- vation of pathology judgment.Conclusions There were 24 cases（29.3%）underestimate the histologic grade by biopsy preoperative.We should pay more attention to this state of underestimate the histologic grade preoperative in the treatment of bladder urothelial carcinoma.更多还原