A minor high‐grade component in non‐invasive papillary urothelial carcinoma is not associated with a more indolent behaviour
Bibliographic record
Abstract
AIMS: The latest WHO edition proposed using a cut-off of ≥5% high-grade component (%HGc) as a criterion to label non-invasive papillary urothelial carcinomas as high-grade (pTaHG). It also suggested that tumours with minor high-grade component behave more indolently and are better labelled as mixed low- and high-grade papillary carcinomas. METHODS AND RESULTS: We investigated the prognostic value of %HGc along with other clinical and morphological parameters. 130 pTaHGs and 96 pTaLGs were included. 9% and 12% of pTaHGs had ≤5% and ≤10% HGc, respectively. Anaplasia was present in six cases (5%), necrosis in 18 cases (14%) and CIS in 5 cases (4%). On average, the highest mitotic count per 1 HPF was 2.4 (range = 0-18), and the mean number of mitoses per 10 HPF was 9 (range: 0-93). The mean tumour diameter was 2.1 cm. Tumour multifocality was observed in 32 cases (25%). Among the histological parameters, only mitotic activity showed a correlation with the %HGc (P < 0.001). While recurrence was not significantly different between pTaLGs and pTaHGs (25% vs 35%; P = 0.09), stage progression was significantly different (0% vs 8%; P = 0.005). The two parameters that were associated with recurrence in pTaHGs were tumour multifocality and BCG therapy, while none was associated with progression. %HGc ≤5% and ≤ 10% did not correlate with lower rates of recurrence nor progression. CONCLUSIONS: Those findings suggest that pTaHGs with minor HGc do not exhibit more indolent behaviour and should not be approached similar to pTaLGs. [Correction added on 13 April 2026, after first online publication: This version changes the preceding sentence from "should be approached" to "should not be approached".].
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".