Blomjous C E, Vos W, Schipper N W, De Voogt H J, Baak J P, Meijer C J
Department of Pathology, Free University Hospital, Amsterdam, The Netherlands.
J Clin Pathol. 1989 Oct;42(10):1032-9. doi: 10.1136/jcp.42.10.1032.
Eighteen cases of primary small cell carcinoma of the bladder were studied. Three patients survived for two years and one survived for five years, which was significantly worse when compared with poorly differentiated transitional cell carcinoma (WHO grade 3). Aggressive tumour behaviour was independent of the presence of neuroendocrine characteristics. Morphometric analysis showed that the nuclear size, which was comparable with that reported in pulmonary small cell carcinoma, was significantly smaller than in poorly differentiated transitional cell carcinoma. Nuclear morphometry may therefore help identify small cell bladder carcinoma, especially in the absence of neuroendocrine differentiation characteristics. DNA flow cytometry of paraffin wax embedded specimens showed aneuploidy in 14 tumours--five were peritetraploid and two multiple aneuploid--and only three were diploid. Aggressiveness of small cell bladder carcinoma usually coincides with aneuploidy in most cases, but diploid tumours may also follow a rapid, lethal clinical course.
对18例原发性膀胱小细胞癌进行了研究。3例患者存活了两年，1例存活了五年，与低分化移行细胞癌（WHO 3级）相比，预后明显更差。侵袭性肿瘤行为与神经内分泌特征的存在无关。形态计量分析表明，核大小与肺小细胞癌报道的相当，但明显小于低分化移行细胞癌。因此，核形态计量学可能有助于识别膀胱小细胞癌，尤其是在缺乏神经内分泌分化特征的情况下。石蜡包埋标本的DNA流式细胞术显示，14例肿瘤为非整倍体——5例为近四倍体，2例为多倍体非整倍体——只有3例为二倍体。在大多数情况下，膀胱小细胞癌的侵袭性通常与非整倍体一致，但二倍体肿瘤也可能遵循快速致命的临床病程。
