Morphometric and immunohistochemical characterization of bladder carcinoma in situ and its preneoplastic lesions.

We performed a morphometric and immunohistochemical study of 26 bladder carcinoma in situ (Cis) specimens, compared with normal urothelium and urothelial preneoplastic lesions. The following morphometric parameters were evaluated: nuclear area, nuclear perimeter and maximum nuclear diameter. For the immunohistochemical study we used five lectins, antibodies against four epithelial differentiation antigens, and antibodies against blood group isoantigens. A progressive increase in nuclear size from normal urothelium to dysplastic urothelium and Cis was detected. Nuclear size values in Cis and in high-grade, high-stage bladder carcinomas were similar. The most relevant immunohistochemical results were obtained with CEA, CK, UEA-1 and ABH isoantigens, which show significant immunoreactivity changes in preneoplastic urothelium and Cis when compared with normal urothelium. We conclude that bladder Cis behaves morphometrically and immunohistochemically as an invasive bladder carcinoma, and we emphasize the usefulness of these techniques for detecting flat dysplastic and neoplastic lesions in random bladder biopsies.