导言膀胱病变涵盖广泛的范围,从良性炎症到恶性肿瘤,提出诊断和治疗挑战。尿路上皮癌在膀胱恶性肿瘤中占主导地位,表现出不同的临床表现和预后。目的本研究旨在描述膀胱病变的组织病理学谱和相关的人口统计学特征。临床特征,膀胱镜下发现各种膀胱病变。方法这项前瞻性描述性观察研究在三级护理中心进行了24个月,包括65例膀胱活检,包括经尿道膀胱肿瘤切除术,膀胱镜活检,和膀胱切除术标本。组织病理学检查遵循WHO2022膀胱肿瘤分类和美国癌症联合委员会第八版分期。临床数据,包括年龄,性别,膀胱镜检查结果,出现症状,与组织病理学诊断相关,以探讨膀胱病变的频谱。结果肿瘤病变为主,占92.3%的病例,尿路上皮癌占这些病例的83.33%。在肿瘤性病变中,浸润性高级别尿路上皮癌(36.7%)和非浸润性低级别乳头状尿路上皮肿瘤(20.0%)是最常见的亚型。非肿瘤性病变占7.7%,包括各种形式的膀胱炎。血尿是主要表现症状(81.5%),膀胱镜检查显示大多数病变位于膀胱侧壁。高级别尿路上皮癌主要与固有肌层浸润有关。结论本研究强调了组织病理学检查在诊断和管理膀胱疾病以及区分非肿瘤性和肿瘤性病变中的关键作用。尿路上皮癌,在老年群体中普遍存在,经常表现出肌肉浸润,表明高度肿瘤。在膀胱镜活检中包括肌肉层对于准确诊断至关重要。相反,虽然不太常见,非肿瘤性疾病包括各种形式的膀胱炎。这些发现强调了膀胱镜检查和组织病理学检查等精确诊断工具对于早期发现和治疗膀胱肿瘤的重要性。组织病理学评估提供了必要的预后指导,有助于精确分期和分级,并指导量身定制的治疗策略。
Introduction Urinary bladder lesions encompass a wide spectrum, from benign inflammatory conditions to malignant neoplasms, presenting diagnostic and therapeutic challenges. Urothelial carcinoma predominates among bladder malignancies, exhibiting diverse clinical presentations and prognoses. Objective This study aimed to delineate the histopathological spectrum of urinary bladder lesions and correlate demographic profiles, clinical features, and cystoscopic findings with various bladder lesions. Methods This prospective descriptive observational study spanned 24 months at a tertiary care center, involving 65 cases of urinary bladder biopsies, including transurethral resection of bladder tumors, cystoscopic biopsies, and cystectomy specimens. The histopathological examination followed the WHO 2022 classification of urinary bladder tumors and the American Joint Committee on Cancer eighth edition staging. Clinical data, including age, gender, cystoscopic findings, and presenting symptoms, were correlated with histopathological diagnoses to explore the spectrum of bladder lesions. Results Neoplastic lesions predominated, constituting 92.3% of cases, with urothelial carcinoma comprising 83.33% of these cases. Among neoplastic lesions, invasive high-grade urothelial carcinoma (36.7%) and non-invasive low-grade papillary urothelial neoplasm (20.0%) were the most frequently observed subtypes. Non-neoplastic lesions accounted for 7.7%, including various forms of cystitis. Hematuria was the predominant presenting symptom (81.5%), while cystoscopic examinations revealed that most lesions were situated in the lateral bladder wall. High-grade urothelial carcinomas were mostly associated with muscularis propria invasion. Conclusion This study underscores the critical role of histopathological examination in diagnosing and managing urinary bladder diseases and distinguishing between non-neoplastic and neoplastic lesions. Urothelial carcinoma, prevalent among older age groups, often demonstrated muscle invasion indicative of high-grade tumors. Including the muscle layer in cystoscopic biopsies is crucial for an accurate diagnosis. Conversely, though less common, non-neoplastic conditions encompass various forms of cystitis. These findings highlight the importance of precise diagnostic tools such as cystoscopy and histopathological examination for the early detection and management of bladder neoplasms. Histopathological assessment offers essential prognostic guidance, aids in precise staging and grading, and directs tailored treatment strategies.