Abstract：
Grade is a key prognostic factor in determining progression in nonmuscle invasive papillary urothelial carcinomas. The 2 most common grading methods in use worldwide are the World Health Organization (WHO) 2004 and 1973 schemes. The International Society of Urological Pathology (ISUP) organized the 2022 consensus conference in Basel, Switzerland on current issues in bladder cancer and tasked working group 1 to make recommendations for future iterations of bladder cancer grading. For this purpose, the ISUP developed in collaboration with the European Association of Urology a 10-question survey for their memberships to understand the current use of grading schemes by pathologists and urologists and to ascertain the areas of potential improvements. An additional survey was circulated to the ISUP membership for their opinion on interobserver variability in grading, reporting of urine cytology, and challenges encountered in grade assignment. Comprehensive literature reviews were performed on bladder cancer grading prognosis and interobserver variability along with The Paris System for urine cytology. There are notable differences in practice patterns between North American and European pathologists in terms of used grading scheme and diagnosis of papillary urothelial neoplasm of low malignant potential. Areas of common ground include difficulty in grade assignment, a desire to improve grading criteria, and a move towards subclassifying high-grade urothelial carcinomas. The surveys and in-person voting demonstrated a strong preference to refine current grading into a 3-tier scheme with the division of WHO 2004 high grade into clinically relevant categories. More variable opinions were voiced regarding the use of papillary urothelial carcinoma with low malignant potential.
摘要：
分级是确定非肌肉浸润性乳头状尿路上皮癌进展的关键预后因素。世界范围内使用的两种最常见的分级方法是世界卫生组织（WHO）2004年和1973年的计划。国际泌尿外科病理学会（ISUP）在巴塞尔组织了2022年共识会议，瑞士关于膀胱癌的当前问题，并责成第1工作组为未来的膀胱癌分级迭代提出建议。为此,ISUP与欧洲泌尿外科协会合作开发了一项由10个问题组成的调查，以了解病理学家和泌尿科医师当前使用分级方案的情况，并确定可能改善的领域。向ISUP成员分发了另一项调查，以了解他们对观察者之间的评分差异的意见，尿液细胞学报告，以及年级分配中遇到的挑战。对膀胱癌分级预后和观察者间变异性以及尿液细胞学巴黎系统进行了综合文献综述。在使用的分级方案和低恶性潜能乳头状尿路上皮肿瘤的诊断方面，北美和欧洲病理学家之间的实践模式存在显着差异。共同点包括年级分配的困难，提高评分标准的愿望，以及对高级别尿路上皮癌进行分类的步骤。调查和面对面投票表明，强烈倾向于将当前的等级划分为3级方案，并将2004年WHO的高等级划分为临床相关类别。关于使用恶性潜能低的乳头状尿路上皮癌，发表了更多不同的意见。
