Histological Changes After Fractionated Whole or Partial Irradiation of the Rabbit Urinary Bladder

Effects of x-irradiation on the urinary bladder of male New Zealand rabbits were studied by means of light microscopy 100 weeks after exposure. The absorbed dose was 33, 36 or 39 Gy given in 5 daily fractions administered to the whole, the cranial or the caudal part of the bladder. The changes in the epithelium and in the muscular tissue were dose-dependent while the changes in the submucosa and in the extramuscular layer were not. The transitional epithelium was generally either atrophic or hyperplastic. If dysplastic or neoplastic changes were seen, the involved areas were mostly surrounded by an apparently normally differentiated epithelium and the highly specialized superficial cells lining the bladder cavity were always present. The submucosal and muscular tissues showed fibrosis and changes in blood vessels and, sometimes also in lymph vessels.     

Combined Systemic Chemotherapy and Irradiation of Muscle-Invasive Transitional Cell Carcinoma of the Urinary Bladder

A phase II study is presented, which encompasses the period June 1987 until July 1993, and includes 53 patients with muscle-invasive bladder cancer T2-4b who, due to age and/or poor health (37 cases) or primarily extensive lesions (18 cases), were considered inoperable and for whom treatment with neoadjuvant chemotherapy (cisplatin/methotrexate/leucovorin rescue) and radical irradiation was planned. The total number of intended chemotherapy courses could be delivered without undue toxicity to 46 patients (83%) and 44 subsequently underwent radiotherapy: this modality was, by and large, well tolerated. The primary transurethral resection and chemotherapy produced an objective response in 62% of the 53 patients and in 75% of the 44 evaluable patients. The combined programme produced an objective response in 83% of the 37 evaluable patients, 71% in the 44 patients who completed the combined programme and in 59% of the total group of 53 patients. The follow-up ranged from 3 to 62 months. Radiotherapy increased the total objective response rate, proving effective in approximately 50% of patients who did not respond to chemotherapy. The results of this study are regarded as promising and pave the way for a phase III trial.     

Prospective Comparison of Toxicity and Cosmetic Outcome After Accelerated Partial Breast Irradiation With Conformal External Beam Radiotherapy or Single-Entry Multilumen Intracavitary Brachytherapy

Purpose

This study aimed to prospectively characterize toxicity and cosmesis after accelerated partial breast irradiation (APBI) with 3-dimensional conformal radiation therapy (CRT) or single-entry, multilumen, intracavitary brachytherapy.

The Performance of the Xpert Bladder Cancer Monitor Test and Voided Urinary Cytology in the Follow-up of Urinary Bladder Tumors

BackgroundCystoscopy in complement with urinary cytology represents the gold standard for the follow-up of patients with urinary bladder tumours. Xpert Bladder Cancer Monitor Test (XBC) is a novel mRNA-based urine test for bladder cancer surveillance. The aim of the study was to evaluate the performance of the XBC and voided urinary cytology (VUC) in the follow-up of bladder tumours.Patients and methodsThe XBC was performed on stabilized voided urine and VUC was performed on urine samples. The results were compared to cystoscopic findings and histopathological results after transurethral resection of the bladder lesion.ResultsFor the prediction of malignant histopathological result sensitivity, the specificity and negative predictive value were 76.9%, 9 7.5% and 93.0% for the XBC and 38.4%, 9 7.5% and 83.3%, respectively for VUC. For the prediction of suspicious or positive cystoscopic finding sensitivity, the specificity and negative predictive value were 75.0%, 95.2%, and 93.0% respectively for the XBC and 41.7%, 97.6%, and 85.4% for VUC. The sensitivities for papilary urothelial neoplasms of low malignant potential (PUNLMP), low- and high-grade tumours were 0.0%, 66.7% an d 100.0% for the XBC and 0.0%, 66 .7% and 42.9%, respectively for VUC.ConclusionsThe XBC showed significantly higher overall sensitivity and negative predictive value than VUC and could be used to increase the recommended follow-up cystoscopy time intervals. Complementing the XBC and voided urinary cytology does not improve performance in comparison to the XBC alone.Key words: cystoscopy, Xpert BC Monitor Test, urinary bladder neoplasm, voided urinary cytology     

膀胱部分切除或肿瘤局部切除联合经尿道切除治疗膀胱多发性肿瘤

目的 探讨不能完全经尿道电切的多发性膀胱肿瘤或因各种原因不具备根治性膀胱切除术条件的多发性膀胱肿瘤保留膀胱的治疗方法。方法 在行膀胱部分切除或膀胱肿瘤局部切除的同时经尿道切除开放性手术难以完成的胯胱颈部三角区等部位的膀胱肿瘤。结果 与单纯膀胱部分切除或膀胱肿瘤局部切除治疗多发性膀胱癌的手术相比，联合经尿道切除可使肿瘤切除更加彻底。结论 膀胱部分切除或肿瘤局部切除联合经尿道切除（TUR—BT）治疗膀胱多发性肿瘤，对不具备根治性膀胱切除术条件的多发性表浅和浸润性膀胱癌具有肿瘤切除更彻底、止血效果更好、术后并发症少和恢复快等优点。     

可控低压肠膀胱重建及对肠膀胱粘膜功能细胞灭活的临床应用

１９９１～１９９３年１１月施行了可控低压肠膀胱重建，并同时应用无水乙醇对肠膀胱粘膜功能细胞进行灭活处理，共８例，术后病人仍从原尿道排尿。随访２～１８个月，均自主排尿，原色清无粘液，无代谢紊乱，恢复正常社交活动。全部病人对重建的可控低压肠膀胱满意。文章介绍了手术方法，讨论了本术式获得可控排尿及对肠膀胱粘膜灭活的机理。     

Coexistence of Papillary and Nodular Carcinomas in the Urinary Bladder

Of 203 patients with transitional cell carcinoma of the urinarybladder which had been cystectomized and examined by step-sectioningduring the period between 1969 and 1986, 33 had coexistent papillary,papDlonodular and/or nodular carcinomas in the bladder. Of them,12 (36%) had a history of papillary carcinomas, 26 (79%) hadmultiple rumors and 22 (67%) had a concomitant carcinoma insitu, and/or mucosal dysplasia. Moreover, microscopic papillarystructures were identified in 32 out of the 33 (97%) cases withpapillonodular and/or nodular carcinomas, indicating some ofthe nodular invasive carcinomas in the bladder to have developedfrom papillary carcinomas.     

Prevention of Urinary Bladder Cancer - the Human and Experimental Interface

1. Introduction: Bladder Cancer and the EnvironmentHistorical Aspects2. Geographical Variation in Histopathological Types of Bladder CancerSchistosomiasisArsenic PoisoningChernobyl3. Analytical Epidemiological and Linked Experimental FindingsSmokingAnalgesic AbuseSaccharine4. Histogenesis of Bladder CancersHistopathologyMolecular pathology5. Carcinogens and Modification of Tumour DevelopmentCarcinogensPromoting agentsInhibitory agents6. Prevention of Bladder CancerPrimary Prevention/ Lifestyle Factors/ChemopreventionSecondary Prevention/ Screening/InterventionConclusions     

Urothelial Damage and Tumor Initiation by Urinary Metabolites of Sodium o-Phenylphenate in the Urinary Bladder of Female Rats

Intravesical instillation of 2-phenyl-1,4-benzoquinone (PBQ), a metabolite of sodium o -phenylphenate (Na-OPP), at a concentration of 0.1% in saline caused acute epithelial injury, prolonged inflammation and epithelial hyperplasia in female F344 rats. Ten such instillations of PBQ within 5 weeks resulted in the development of preneoplastic lesions of the urinary bladder epithelium when followed by 5% sodium saccharin feeding for 31 weeks. Since neither urothelial damage nor tumor-initiating activity was observed with either Na-OPP itself or another metabolite, phenylhydroquinone, PBQ may play an essential role in Na-OPP urinary bladder carcinogenesis.     

Effects of Fractionated Irradiation on the Cytoskeleton and Basal Lamina in Parotid Glands: An Immunohistochemical Study

Cytoskeletal, cytocontractile and basement membrane proteins were studied using the immunofluorescence technique in the parotid gland in female rats after half-side fractionated megavoltage irradiation. The non-irradiated parallel-handled parotid glands served as controls. The qualitative expression of cytoskeletal proteins remained unchanged 10 days following irradiation compared to controls, i.e. cytokeratin was observed but not vimentin, desmin or GFAP (glial fibrillary acidic proteins). Six months after irradiation the cytokeratin expression adjacent to duct lumina was clearly stronger. Actin staining was more pronounced in the periphery of the acini. Ten days after irradiation no alterations of the basal lamina proteins, laminin and fibronectin, were detected. Six months post-irradiation laminin deposits were detected in areas where the entire acini had degenerated and had been replaced by fibrosis. An increased expression of fibronectin was also observed in the stroma at that time, reflecting an increased fibrosis. In areas where the acini remained, laminin immunofluorescence was mainly found in basal laminae of normal thickness, but the mean diameter of the acini seemed to have increased. This indicates a regeneration of acini and a restructuring of the basal lamina of the parenchyma.