Fujioka T, Ishii N, Chiba R
Hinyokika Kiyo. 1983 Aug;29(8):869-73.
Since the study of intravesical instillation of thio-TEPA by Jones and Swinney, the method of topical chemotherapy with several anti-cancer drugs for superficial bladder tumors have been reported and it is now an established method of anti-bladder cancer treatment. Adriamycin is one of the most common topical agents against bladder tumor today. We studied the histopathological changes associated with the topical treatment in 26 cases of bladder cancer, all in which either TUR-Bt or cystectomy (partial or radical) had been performed after intravesical instillation of adriamycin. Transurethral biopsies of bladder tumor were done before the chemotherapy, and these findings were histopathologically compared with those of the surgical specimens. In 3 of the 26 cases, the tumors disappeared completely. In the other 23 cases, the main changes were: 1) cellular atrophy of tumor, 2) exfoliation, 3) interstitial hyalinous degeneration, 4) hemorrhage, and 5) dystrophic calcification. These changes are nonspecific of adriamycin, which seems to act as a toxic substance despite its potential activity to inhibit RNA replication.
自琼斯（Jones）和斯温尼（Swinney）对噻替派膀胱内灌注进行研究以来，已报道了多种抗癌药物用于浅表性膀胱肿瘤局部化疗的方法，如今这已成为一种既定的抗膀胱癌治疗方法。阿霉素是目前最常用的抗膀胱肿瘤局部用药之一。我们研究了26例膀胱癌患者局部治疗相关的组织病理学变化，所有患者在膀胱内灌注阿霉素后均接受了经尿道膀胱肿瘤电切术（TUR - Bt）或膀胱切除术（部分或根治性）。化疗前对膀胱肿瘤进行经尿道活检，并将这些结果与手术标本的组织病理学结果进行比较。26例中有3例肿瘤完全消失。在其他23例中，主要变化有：1）肿瘤细胞萎缩，2）剥脱，3）间质透明变性，4）出血，5）营养不良性钙化。这些变化并非阿霉素所特有，尽管其具有抑制RNA复制的潜在活性，但似乎仍作为一种有毒物质起作用。
