ABSTRACT
La citología urinaria es un precedimiento aceptado en el diagnóstico y seguimiento del carcinoma transicional (CT) de vrjiga. Para estudiar su sensibilidad y evaluar parámetros pronósticos, realizamos el análisis de ADN a muestras de orina de 72 pacientes con CT de vejiga comprobado histológicamente. Se examinaron los extendidos realizados con citocentrífuga y coloreadas con técnica de papanicolau convencional. Los mismos extendidos, obtenidos de muestras previas a la biopsia, fueron decolorados y recoloreados de acuerdo con la técnica de Feulgen. Con un analizados de imágenes se evaluó la ploidía nuclear, el grado de malignidad (GM)(Bocking y colaboradores, 1986) y los eventos mayores de 5c (5cE). El seguimiento clínico promedio fue de 33 meses. La citología convencional con técnica de Papanicolau fue positiva en 44 casos (61,11 por ciento), que incluían 6/17 CT grado (G)I: 24/35 GII y 14/20 GIII. Los histogramas fueron diploides en 9 casos (12,5 por ciento), y aneuploides en 63 (87,5 por ciento); fueron aneuploides en 13/17 de los tumores GI (76,5 por ciento), 32/35 GIII (91,4 por ciento), y 18/20 GIII (90 por ciento). Combinando los dos métodos, la positividad total fue de 65/72 (93,05 ppor ciento). Se encontraron diferencias estadísticas significativas cuando se correlacionó el índice de ADN (p<0,02), GM (p<0,001) y 5cE (p<0,001) con la sobrevida global y libre de enfermedad. El análisis de ADN es útil para aumentar la sensibilidad de la citología urinaria. Los datos de esta serie indican también que la determinación del índice de ADN, GM y 5cE por AI son de valor pronóstico en CT de vejiga
Subject(s)
Humans , Cytological Techniques , DNA/analysis , Urinary Bladder Neoplasms/diagnosis , Urinary Bladder Neoplasms/ultrastructure , Urinary Bladder Neoplasms/urine , Carcinoma/historyABSTRACT
Three cases of spindle cell neoplasms of the urinary bladder were subjected to EM study. They showed haphazard arrangement of myofilaments, abundant rough endoplasmic reticulum and free ribosomes. Irregular nuclear borders and frequent nuclear clefts with irregularly clumped chromatin were also evident. Infrequent pinocytic vesicles were also seen. These features differentiate clearly between these types of tumors on one hand and sarcomatoid carcinoma, spindle cell fibrotic nodules and inflammatory pseudotumor on the other hand
Subject(s)
Humans , Male , Urinary Bladder Neoplasms/ultrastructureABSTRACT
4742 cases of bladder cancer out of 48080 cancer cases, which were registered at Iraqi Cancer Registry Centre in Baghdad during 1976-1987, were studied histopathologically and analysed epidemiologically, concerning sex, age, occupation and association with bilharziasis. Surgical and biopsy materials as well as urine sediments of some patients with bilharzia bladder cancer were prepared for scanning electron microscopy. Male to female ratio was 3:1 with high incidence at age of 60-69, being most common among farmers[88%]. Squamous cell carcinoma[SCC] was dominant [46.5%] during the years 1976-1985 when compared with transitional cell carcinoma[TCC][37.7%]. SCC with bilharziasis to TCC with bilharziasis ratio was 4:1. But the number of TCC surpassed SCC cases [8:7] during 1986 and 1987, indicating possible environmental factors other than schistosomiasis, after successful antibilharziasis campaigns for the past 30 years. Ultrastructural study revealed pleomorphic microvilli and cilia on the surface of malignant urothelium, while normal one showed reticular microridges only. A quick dipping method was developed in order to utilize scanning electron microscopy for early detection of bladder cancer in high risk people. Annual urine analysis with combined light and scanning electron microscopy are suggested. Preventive measures were recommended including continuous anti-bilharziasis campaign and avoidance of nitrate contamination in rural areas, where chemical fertilizers and insecticides are widely used nowadays
Subject(s)
Humans , Male , Female , Schistosomiasis haematobia/complications , Urinary Bladder Neoplasms/epidemiology , Urinary Bladder Neoplasms/ultrastructure , Schistosomiasis/prevention & controlABSTRACT
Urinary bladder carcinoma in Schistosoma cases presented a pllomorphic character; it shared many properties with transitional and squamous cell carcinomata though it had certain specific features. Electronumicrographs of exfoliated tumour cells in urine sediment showed clearly the criteria of malignancy. A cytopathological correlation was markedly noticed. As the medical library is still deficient in an easy and reliable mean for early detection of carcinoma in bilharzial urinary bladder a method was suggested for the use of electromicroscopy in urinary cytology for diagnosis of malignancy