An ultrastructural and morphometric study of bladder tumours (I)
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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.
Key wordsElectron microscopy Bladder neoplasms Measurement
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