Virchows Archiv

, Volume 443, Issue 6, pp 734–740

Reproducibility of the 1998 World Health Organization/International Society of Urologic Pathology classification of papillary urothelial neoplasms of the urinary bladder

  • Kutsal Yorukoglu
  • Burcin Tuna
  • Emel Dikicioglu
  • Ender Duzcan
  • Aydin Isisag
  • Sait Sen
  • Ugur Mungan
  • Ziya Kirkali
Original Article



This study assessed the diagnostic agreement and intra- and inter-observer reproducibility of the World Health Organization/International Society of Urologic Pathology Consensus Classification of Urothelial Neoplasms (1998 WHO/ISUP classification) and the 1973 WHO classification.


A teaching set with 5 slides of each papillary neoplasm of low malignant potential, low-grade papillary carcinoma, high-grade papillary carcinoma, and a guideline, as well as a study set of 30 slides containing ten cases of each category, were sent to participants. Six pathologists expert in urological pathology reviewed the 30 slides of non-invasive papillary urothelial tumors in the study set. Diagnostic accuracy and reproducibility were evaluated using intra- and inter-rater techniques (kappa statistic).


A moderate to substantial intra- and inter-observer reproducibility was achieved for both the 1998 WHO/ISUP and 1973 WHO classification. The results of the two classification systems were not different statistically (P>0.05). Reproducibility was lower in low-grade tumors for both classifications.


The new proposed classification system for non-invasive urothelial neoplasms does not increase the reproducibility. There is still a need for uniformity in grading in order to compare the different studies and therapies and to provide more accurate information for management.


Bladder neoplasms Urothelium World Health Organization Classification 


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Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  • Kutsal Yorukoglu
    • 1
  • Burcin Tuna
    • 1
  • Emel Dikicioglu
    • 2
  • Ender Duzcan
    • 3
  • Aydin Isisag
    • 4
  • Sait Sen
    • 5
  • Ugur Mungan
    • 6
  • Ziya Kirkali
    • 6
  1. 1.School of Medicine, Department of PathologyDokuz Eylul UniversityIzmirTurkey
  2. 2.School of Medicine, Department of PathologyAdnan Menderes UniversityTurkey
  3. 3.School of Medicine, Department of PathologyPamukkale UniversityTurkey
  4. 4.School of Medicine, Department of PathologyCelal Bayar UniversityTurkey
  5. 5.School of Medicine, Department of PathologyEge UniversityTurkey
  6. 6.School of Medicine, Department of UrologyDokuz Eylul UniversityIzmirTurkey

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