Proliferative pattern of urothelial bladder cancer and urothelial atypias

Abstract

For early diagnosis of urinary bladder tumors, autoradiographic, cytological, and impulse cytophotometric examinations were performed on fresh bladder tissue with carcinomas of different grades of malignancy and various depths of infiltration, and also on tissues with concomitant urothelial atypias. Cell kinetic examinations of urothelial atypias of mild, moderate, and severe grade revealed labeling indices comparable to those of urothelial carcinomas grade I, II, and III, respectively. The labeling indices of the carcinomas increased with both the grades of malignancy and the depth of invasion up to factor 5. Cytophotometrically mild atypias showed euploidy, while moderate to severe atypias revealed aneuploidy. By means of cytologic, cytophotometric, and cell kinetic analyses, two subgroups of G I urothelial carcinomas were distinguished. Subgroup I a corresponded to highly differentiated papillary urothelial carcinomas with low labeling indices, pap I-III differentiation, and euploidy. Subgroup I b, on the other hand, revealed pap differentiations of IV-V, aneuploidy, and higher labeling indices. This subgroup seems to be more prone to recurrences and apparently indicates higher grades of malignancy and depths of infiltration. The data presented provide evidence that a combination of these methods is helpful for early recognition of precursors of bladder cancer atypias as well as for exact evaluation of the biological potential of carcinomas.

Grading and Prognostic Significance of Urologic Carcinomas

“…55, 72.65 and 100%, respectively [85]. The DNA synthesis times that can be measured in vitro by double labelling are long in low malignant urothelial neoplasias and short in highly malignant tumors [86][87][88][89][90], Comparable results can be obtained immunohistochemically by the use of anlibromodeoxyuridine antibodies. The labelling index is 3 times higher than that in normal urothelium (5 vs. 13%).…”

Maligne Tumoren der Harnblase im Biopsiegut der Jahre 1977-1980 und 1988

“…Der Trend einer Zunahme des Anteils weiblicher Patienten von 1977-1979 bis 1988 in unserem Untersuchungsgut stimmt mit den Erfahrungen anderer Autoren überein (4,13). Das von uns gefundene Verhältnis Männer/Frauen von 2,5 : 1 stellt, gemessen an der Literatur, allerdings einen Extremwert dar: üblich sind Werte von 2,8 : 1(31)bis 3,8 : 1 (18,29). Diese Angabenim Schrifttum stützen sich jedoch auf Erhebungen, die vor mehreren Jahren abgeschlossen wurden, während in der vorliegenden Studie noch das Jahr 1988 erfaßt wird, in dem sich der o.g.…”

“…Über 80% der Karzinome entstammten dem Übergangsepithel, die Verteilung entspricht derjenigen anderer Arbeiten (2,16,18,30). Da mit einigen Kanzerogenen ein bestimmtes Karzinomwachstum verbunden wird (25), ergibt sich die Frage, ob der über die Jahre etwa gleichbleibende Anteil von Übergangsepithelkarzinomen in unserem Untersuchungsgut Ausdruck einer relativ unveränderten Exposition in der Vergangenheit ist.…”