Corica F A, Husmann D A, Churchill B M, Young R H, Pacelli A, Lopez-Beltran A, Bostwick D G
Department of Pathology, Mayo Clinic, Rochester, MN 55905, USA.
Urology. 1997 Sep;50(3):427-31. doi: 10.1016/S0090-4295(97)00294-X.
Intestinal metaplasia often coexists with adenocarcinoma of the urinary bladder, suggesting to some investigators that it is premalignant. However, the natural history and long-term outcome of intestinal metaplasia in isolation are unknown. We report 53 cases of intestinal metaplasia of the urinary bladder followed for more than 10 years.
We reviewed the Mayo Clinic surgical pathology files between 1926 and 1996 and all patients with exstrophic bladder recorded in the files of the Hospital for Sick Children (Toronto, Ontario, Canada) and Dallas Children's Hospital (Dallas, Texas) between 1953 and 1987, and identified all patients with intestinal metaplasia of the bladder.
A total of 53 cases were identified from both series, and none of the patients developed adenocarcinoma of the bladder. The Mayo Clinic series consisted of 24 patients. Nineteen of the 24 (79.1%) were alive without evidence of cancer (median follow-up 14 years, range 0.9 to 53), and 5 patients died of intercurrent disease (at 0.9, 4, 8, 11, and 53 years after diagnosis) without evidence of bladder cancer. The Dallas Children's Hospital and the Hospital for Sick Children series consisted of 29 patients. Twenty-seven of the 29 (93.1%) were alive without evidence of cancer (median follow-up 13 years, range 3 to 23.9). Two patients died of trauma (at 10.9 and 12 years after diagnosis) and at autopsy had no evidence of bladder cancer.
Intestinal metaplasia of the urinary bladder is not a strong risk factor for adenocarcinoma or urothelial cancer.
肠化生常与膀胱腺癌并存，这使得一些研究者认为它是癌前病变。然而，孤立性肠化生的自然病程和长期转归尚不清楚。我们报告了53例随访超过10年的膀胱肠化生病例。
我们查阅了梅奥诊所1926年至1996年的外科病理档案，以及加拿大多伦多病童医院（安大略省多伦多）和得克萨斯州达拉斯儿童医院1953年至1987年档案中所有膀胱外翻患者的记录，并确定了所有膀胱肠化生患者。
两个系列共识别出53例病例，所有患者均未发生膀胱腺癌。梅奥诊所系列包括24例患者。24例中的19例（79.1%）存活且无癌症证据（中位随访14年，范围0.9至53年），5例患者死于并发疾病（诊断后0.9、4、8、11和53年），无膀胱癌证据。达拉斯儿童医院和病童医院系列包括29例患者。29例中的27例（93.1%）存活且无癌症证据（中位随访13年，范围3至23.9年）。2例患者死于创伤（诊断后10.9年和12年），尸检无膀胱癌证据。
膀胱肠化生不是腺癌或尿路上皮癌的强危险因素。
