Schapers R F, Pauwels R P, Havenith M G, Smeets A W, van den Brandt P A, Bosman F T
Department of Pathology, Stichting Ziekenhuizen Venlo-Venray, The Netherlands.
Cancer. 1990 Dec 15;66(12):2583-8. doi: 10.1002/1097-0142(19901215)66:12<2583::aid-cncr2820661222>3.0.co;2-s.
Invasion of a carcinoma involves the degradation and penetration of the subepithelial basement membrane (BM). This phenomenon might be used for histopathologic evaluation of neoplasms of the bladder. The authors studied the clinicopathologic data and tissue specimens of 125 cases of urothelial carcinomas collected prospectively. Penetration of the BM was evaluated by immunohistochemical staining of the BM components laminin and type IV collagen. The use of this parameter as a prognostic indicator in bladder cancer was assessed. The 5-year survival rate of patients having tumors with an interrupted or absent BM was significantly lower than that of patients having tumors with an intact BM. The rate of progression was greater in tumors with an interrupted or absent BM than in tumors with an intact BM. No association was found between BM status and recurrence. However, a significant correlation between tumor stage and BM staining was found. A correlation was also found between ploidy and BM staining as well as between histologic grade and BM staining pattern. When evaluating histologic grade, stage, ploidy, age, and BM score as prognostic parameters, the stage of bladder carcinomas turned out to be the most important factor in predicting the survival rate and the progression-free survival. However, BM staining was found to be of value for early identification of microinvasion and is helpful for correct staging of urothelial carcinomas.
癌的浸润涉及上皮下基底膜（BM）的降解和穿透。这种现象可用于膀胱肿瘤的组织病理学评估。作者前瞻性地研究了125例尿路上皮癌的临床病理资料和组织标本。通过对BM成分层粘连蛋白和IV型胶原进行免疫组织化学染色来评估BM的穿透情况。评估了该参数作为膀胱癌预后指标的用途。基底膜中断或缺失的肿瘤患者的5年生存率显著低于基底膜完整的肿瘤患者。基底膜中断或缺失的肿瘤的进展率高于基底膜完整的肿瘤。未发现基底膜状态与复发之间存在关联。然而，发现肿瘤分期与基底膜染色之间存在显著相关性。还发现倍体与基底膜染色之间以及组织学分级与基底膜染色模式之间存在相关性。在将组织学分级、分期、倍体、年龄和基底膜评分作为预后参数进行评估时，膀胱癌的分期是预测生存率和无进展生存期的最重要因素。然而，发现基底膜染色对于早期识别微浸润有价值，并且有助于尿路上皮癌的正确分期。
