Schade R O, Swinney J
J Urol. 1983 Jun;129(6):1125-6. doi: 10.1016/s0022-5347(17)52603-8.
More than 10 years ago we reported on the histological appearance and clinical significance of random biopsies of the intervening urothelium in 100 patients with transitional cell carcinoma of the bladder. Although the biopsied mucosa appeared normal cystoscopically a surprisingly large number of abnormalities were found: only 5 per cent of the patients had normal urothelium, 40 per cent had established carcinoma in situ and the remaining 55 per cent had changes described variously as cystitis glandularis, atypia and metaplasia. In the intervening decade these patients have been followed carefully and have been reviewed to determine their fate. Of the original 100 cases 92 were sufficiently well documented to make a meaningful analysis. The outstanding finding was that patients with carcinoma in situ had a significantly worse outcome statistically than those with normal mucosa or nonmalignant aberrations regardless of the characteristics of the primary tumor and its grade or stage (p less than 0.001). A detailed analysis is presented in relation to the clinical and experimental findings, suggesting that patients with carcinoma in situ associated with the primary tumor may require treatment to supplement the initial tumor resection.
10多年前，我们报告了对100例膀胱移行细胞癌患者进行的间歇性尿路上皮随机活检的组织学表现及临床意义。尽管活检的黏膜在膀胱镜检查时看似正常，但却发现了数量惊人的异常情况：只有5%的患者尿路上皮正常，40%已确诊为原位癌，其余55%有各种不同描述的改变，如腺性膀胱炎、异型性和化生。在随后的十年里，我们对这些患者进行了仔细随访并复查以确定其病情转归。在最初的100例病例中，92例有足够完整的记录可供进行有意义的分析。最显著的发现是，无论原发肿瘤的特征及其分级或分期如何，原位癌患者在统计学上的预后明显比黏膜正常或非恶性异常的患者差（P<0.001）。结合临床和实验结果进行了详细分析，提示与原发肿瘤相关的原位癌患者可能需要在初始肿瘤切除之外进行其他治疗。
