Clinicopathological differences and prognosis between high-grade urothelial carcinoma and low-grade urothelial carcinoma

HUA Hao-ming; WANG Lin-ru; YU Na; HUANG Yan; SHEN Jing; WANG Hong-qun

doi:10.3969/j.issn.1007-8096.2025.02.006

Abstract：Objective To investigate the clinicopathological differences between high-grade and low-grade urothelial carcinoma,and to provide basis for the diagnosis and prognosis of urothelial carcinoma.Methods A total of 197 cases of urothelial carcinoma were collected,and the differences of clinicopathological factors between high-grade group and low-grade group were analyzed and compared,and the factors of affecting the prognosis were analyzed.Results The age of onset ranged from 27 to 89 years,with a median age of 67 years.The high-grade group had an older age,and greater depth of invasion than the low-grade group;the incidence of tumor thrombus and distant metastasis was higher,and the tumors were larger than those of the low-grade group;there were also differences in the location of occurrence(all P＜0.05).In the low-grade group,Ki-67 indes was ≦ 10％,while in the high-grade group,Ki-67 was mostly＞10％(47/48,97.9％)(P＜0.05),and the overall survival time(OS)of patients with Ki-67 ≧ 20％was shortened(P=0.013).The CPS score showed that PD-L1＞10 had a higher positive expression rate in the high-grade group(63.3％,19/30,P＜0.001),and the OS of PD-L1＞10 group was shortened(24.378±4.381vs.33.806±2.886 months,P=0.023).Univariate survival analysis showed that the clinicopathological factors of affecting OS were as follows:age,tumor grade,degree of invasion,tumor size,tumor thrombus,lymph node metastasis,distant metastasis and location.Multivariate Cox regression analysis showed that distant metastases,tumor thrombus,tumor size and degree of invasion were independent prognostic factors for OS.Conclusion There are many clinicopathological differences between high-grade and low-grade urothelial carcinoma,as follows,age,size,depth of invasion,location,the incidence of tumor thrombus and distant metastasis,and prognosis,etc.Ki-67 and PD-L1 can be used as a marker for grading and prognosis.Several factors influence the prognosis of urothelial carcinoma.