RESUMO
Accurate staging and grading of bladder neoplasms, which are the most important guides for the treatment of transitional cell carcinoma [TCC], depend seriously on the interpretation of tumor biopsies by pathologists and are largely subject to inter- and intrapathologist variations. Therefore, it appears that clinicians should have additional guides to appropriately diagnose and treat high-risk patients. We evaluated the association of the grade of TCC of the urinary bladder with four patient's variables, i.e., age, gender, cigarette smoking, and opium consumption, to find out if any of them could serve as a guide for clinicians. A retrospective study was performed on 255 individuals in whom TCC was diagnosed. Correlations between the grade of TCC and clinical features were determined. Age was not correlated with tumor grade [P = 0.59], but cigarette smoking [P = 0.032] and male gender [P = 0.029] showed positive associations with higher grades. The association between male gender and higher grades is probably due to the higher incidence of cigarette smoking among men [P < 0.001], making this correlation spurious. Because opium consumption had a significant correlation with smoking [P < 0.001], its correlation [P = 0.012] with high grades of TCC could not be validated as accurate. Cigarette smokers and males [according to a high prevalence of cigarette smoking among males] are more prone to develop high grades of urinary bladder TCC. In these high-risk groups, there should be a low threshold for the review of pathologic material if the primary pathological examination shows a low-grade carcinoma, for adjuvant treatment [intravesical therapy], and for careful follow-up after the treatment-especially when pathological differentiation between the grades is difficult