Urinary bladder carcinogenesis induced by chronic exposure to persistent low-dose ionizing radiation after Chernobyl accident

Malignancies after Chernobyl Accident: What Is True and What Is Untrue

“…Such a high prevalence of severe dysplasia and CIS in randomly selected BPH cases is obviously unrealistic and indicative of false-positivity. Radiation doses resulting from activity concentration of 137Cs in urine (6.47 Bq/l in the most exposed group [43,44]) were discussed previously [47]: the doses were obviously too low to cause any increase in bladder malignancy.…”

“…Diagnostic uncertainty is an apparent explanation for the fact that in different groups of males with benign prostatic hyperplasia (BPH) and females with chronic cystitis, from contaminated areas and Kiev, severe urothelial dysplasia and carcinoma in situ (CIS) were found by bladder biopsy as frequently as in 56-92 % of all randomly selected cases; while the random selection mode was repeatedly pointed out [42][43][44][45][46]. Such a high prevalence of severe dysplasia and CIS in randomly selected BPH cases is obviously unrealistic and indicative of false-positivity.…”

“…It should be stressed that overdiagnosis of premalignant and malignant bladder lesions entails overtreatment and overmanipulation including cystoscopies and repeated biopsies [42][43][44][45][46], which could have been conductive to a transmission of infection such as viral hepatitis [48,49]. It seems to be probable that the so-called "irradiation cystitis" [44,50], characterized not only by urothelial dysplasia and CIS but also by "reactive epithelial proliferation associated with hemorrhage, fibrin deposits, fibrinoid vascular changes, and multinuclear stromal cells" [50], was at least in part caused by repeated cystoscopies, biopsies, electrocoagulation etc.…”

“…It seems to be probable that the so-called "irradiation cystitis" [44,50], characterized not only by urothelial dysplasia and CIS but also by "reactive epithelial proliferation associated with hemorrhage, fibrin deposits, fibrinoid vascular changes, and multinuclear stromal cells" [50], was at least in part caused by repeated cystoscopies, biopsies, electrocoagulation etc. Accordingly, it can be assumed that some of molecular markers, especially those associated with tissue damage, inflammation and cell proliferation (TGF-β1, NF-κB, p38 mitogen-activated protein kinases, growth factors, etc.…”

“…Accordingly, it can be assumed that some of molecular markers, especially those associated with tissue damage, inflammation and cell proliferation (TGF-β1, NF-κB, p38 mitogen-activated protein kinases, growth factors, etc. ), as well as the "marked activation of angiogenesis in urinary bladder lamina propria" [44], reflected chronic inflammation and increased cellular proliferation unrelated to ionizing radiation. In this regard, the images from Romanenko et al [44,46] reproduced in Jargin [51,52] should be commented: All the slides are too thick for reliable diagnostics, nuclei are weakly stained.…”