Abou Farha K M, Janknegt R A, Kester A D, Arends J W
Department of Urology, Maastricht University Hospital, The Netherlands.
Urol Int. 1993;50(3):133-40. doi: 10.1159/000282471.
A prospective immunohistochemical study of 66 human bladder biopsies with and without transitional cell carcinoma (TCC) of the bladder was performed to assess the diagnostic and prognostic value of laminin staining in TCC of the human bladder. In all normal and nonmalignant inflammatory specimens, a continuous intact basement membrane (BM) laminin could be identified. In bladder cancer specimens laminin staining revealed focal interruption of the subepithelial BM with microinvasion in 2 of 6 specimens initially diagnosed as Tis(Pis) and 7 of 25 specimens initially diagnosed as pTa tumors. A statistically significant association between the pT category and BM interruption was found (p < 0.025). BM loss was directly proportional with the stage of the tumor. However, no significant association could be observed between BM interruption and the grade of the tumor (p > 0.25). In a short-term follow-up (mean 16 months) a statistically significant correlation (p = 0.01) could be observed between tumor recurrence and BM integrity in that a higher recurrence rate and shorter recurrence-free interval was found in patients with interrupted BM versus those with intact BM. Assessment of the vascular BM-staining pattern revealed interruption in specimens from 5 patients who died from advanced metastatic tumors. The metastatic process was found to be closely associated with focal interruption of the subendothelial BM (p < 0.001). From our results it appears that the adjunct use of immunohistochemical laminin staining in the histopathologic examination of TCC of the bladder is essential in more exact identification of the different pathologic stages and is also of help in the more detailed prediction of tumor behavior and prognosis.
对66例有或无膀胱移行细胞癌（TCC）的人膀胱活检组织进行了前瞻性免疫组织化学研究，以评估层粘连蛋白染色在人膀胱TCC中的诊断和预后价值。在所有正常和非恶性炎症标本中，均可识别出连续完整的基底膜（BM）层粘连蛋白。在膀胱癌标本中，层粘连蛋白染色显示，最初诊断为Tis（Pis）的6例标本中有2例以及最初诊断为pTa肿瘤的25例标本中有7例，其上皮下BM有局灶性中断并伴有微侵袭。发现pT类别与BM中断之间存在统计学上的显著关联（p < 0.025）。BM缺失与肿瘤分期直接相关。然而，未观察到BM中断与肿瘤分级之间存在显著关联（p > 0.25）。在短期随访（平均16个月）中，观察到肿瘤复发与BM完整性之间存在统计学上的显著相关性（p = 0.01），即BM中断的患者与BM完整的患者相比，复发率更高且无复发生存期更短。对血管BM染色模式的评估显示，5例死于晚期转移性肿瘤患者的标本中有中断情况。发现转移过程与内皮下BM的局灶性中断密切相关（p < 0.001）。从我们的结果来看，在膀胱TCC的组织病理学检查中辅助使用免疫组织化学层粘连蛋白染色对于更准确地识别不同病理阶段至关重要，并且在更详细地预测肿瘤行为和预后方面也有帮助。
