title: Squamous and/or glandular differentiation in urothelial carcinoma: prevalence and significance in transurethral resections of the bladder.
abstract: BACKGROUND
  It is controversial if urothelial carcinoma of the bladder with squamous and/or glandular differentiation is a more aggressive neoplasm than conventional urothelial carcinoma.
  
  
  METHODS
  A total of 165 transurethral resections of the bladder were reviewed. A group with squamous and/or glandular differentiation was compared to a group without this finding. The chi-square test was used to assess the association of the groups with stage (TNM, 1997).
  
  
  RESULTS
  Of the total of 165 transurethral resections of the bladder, 153 (92.72%) were conventional urothelial carcinomas and 12 (7.27%) showed squamous and/or glandular differentiation. The distribution according to stage was 84 (54.9%), 35 (22.9%) and 34 (22.2%) for the group without differentiation and 0 (0%), 3 (25%) and 9 (75%) for the group with squamous and/or glandular differentiation, respectively for stages pTa, pT1 and pT2. Tumors with squamous and/or glandular differentiation showed a significant statistical correlation to higher stage at clinical presentation (p < 0.0001). There was no significant statistical relation according to age (p = 0.8433), sex (p = 0.5672) or race (p = 0.3137).
  
  
  CONCLUSIONS
  The results suggest that urothelial bladder carcinomas with squamous and/or glandular differentiation are more aggressive neoplasms. There was a significant statistical correlation between tumors with this differentiation and higher stage at clinical presentation.
authors.affiliation: Department of Anatomic Pathology, School of Medicine, State University of Campinas (UNICAMP), Campinas, Brazil. athanase@fcm.unicamp.br
authors.forename: A
authors.initials: A
authors.lastname: Billis
authors.forename: A A
authors.initials: AA
authors.lastname: Schenka
authors.forename: C C
authors.initials: CC
authors.lastname: Ramos
authors.forename: L T
authors.initials: LT
authors.lastname: Carneiro
authors.forename: V
authors.initials: V
authors.lastname: Araújo
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D006801:Humans; D009367:Neoplasm Staging; D012189:Retrospective Studies; D001749:Urinary Bladder Neoplasms / Q000473:pathology*