The ultrastructure of urothelium from 4 patients with no evidence of tumour was compared with that taken from 22 patients with bladder neoplasms of different grade and stage. Two features were quantified: the percentage of reduplication of the basal lamina and the percentage of discontinuous basal lamina.
Tumours showed a lower percentage of reduplicated basal laminae than normal tissues, the difference being significant in 3 out of 4 types of tumours. The difference in frequency between normal tissues and non-recurring tumours was not significant, but there was a significant difference between normals and recurring tumours.
All types of tumours showed discontinuities in the basal lamina, including 80% of those staged non-invasive by light microscopy. None of the normal tissues showed these. The percentage of discontinuities seen in non-recurrent tumours was half that seen in recurrent ones, but both groups were significantly higher than normals.
Loss of continuity of the basement membrane distinguishes invasive from non-invasive tumours. However, there is a high probability of these being missed by light microscopy alone. Therefore, electron microscopic studies on recurrent bladder tumours would increase the accuracy of staging and prognosis.
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Smith, A.F. An ultrastructural and morphometric study of bladder tumours (I). Virchows Arch. A Path. Anat. and Histol. 390, 11–21 (1981). https://doi.org/10.1007/BF00443895
- Electron microscopy
- Bladder neoplasms