New concepts of histological changes in experimental augmentation cystoplasty: Insights into the development of neoplastic transformation at the enterovesical and gastrovesical anastomosis
New concepts of histological changes in experimental augmentation cystoplasty: Insights into the development of neoplastic transformation at the enterovesical and gastrovesical anastomosis
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DOI：
10.1016/s0022-5347(01)68080-7
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发表时间：
1999-09-01
影响因子：
6.6
通讯作者：
Shapiro, E
中科院分区：
文献类型：
--
作者：
Gitlin, JS;Wu, XR;Shapiro, E
目的：据我们所知，与回肠膀胱成形术、输尿管乙状结肠造口术和回肠导管相关的恶性肿瘤的发病机制目前尚不清楚。为了进一步了解肿瘤转化的机制，我们研究了犬膀胱增大成形术模型的组织学变化。材料和方法：使用5至7厘米进行肠膀胱成形术和胃膀胱成形术。 8只狗的回肠斑块和6只狗的胃窦斑块。术后4个月收获标本。代表3μm。肠膀胱和胃膀胱连接处的切片用苏木精和伊红染色。使用间接过氧化物酶方法评估尿斑蛋白的表达，并用阿新蓝和高碘酸-希夫试剂进行双重染色。结果：增强性膀胱成形术的膀胱部分具有 3 至 4 个复层细胞层，上面覆盖着独特的伞状细胞层。除基底层外，所有细胞层均可见强烈的尿斑蛋白染色。在肠膀胱和胃膀胱交界处，有 6 至 10 层增生的尿路上皮细胞覆盖回肠和胃段的腺上皮。这些细胞表达尿斑蛋白。在这个交界区，下面的肠腺明显减少，其萎缩程度与尿路上皮增生的程度成比例。用阿新蓝和高碘酸-希夫试剂对尿斑蛋白染色切片进行双重染色，显示覆盖肠段的增生性尿路上皮细胞中存在粘液物质，表明这些细胞共表达尿斑蛋白和粘蛋白。结论：该实验性犬膀胱增大成形术模型的组织学变化表明，增生性移行上皮过度生长发生在肠膀胱和胃膀胱交界处。这些细胞不仅表达尿斑蛋白，还表达粘液物质。我们的结果表明，迁移的增生性尿路上皮细胞经历了肠和胃上皮特征的变化，这可能对膀胱增大恶性肿瘤的发病机制具有重要意义。
Purpose: To our knowledge the pathogenesis of malignancy associated with ileal cystoplasty, ureterosigmoidostomy and ileal conduits is currently unknown. To gain further insights into the mechanism of neoplastic transformation we studied histological changes in a canine augmentation cystoplasty model.Materials and Methods: Enterocystoplasty and gastrocystoplasty were performed using a 5 to 7 cm. patch of ileum in 8 dogs and gastric antrum in 6. Specimens were harvested 4 months postoperatively. Representative 3 mu m. sections of the enterovesical and gastrovesical junctions were stained with hematoxylin and eosin. Uroplakin expression was assessed using an indirect peroxidase method subjected to double staining with alcian blue and periodic acid-Schiff reagent.Results: The bladder portion of the augmentation cystoplasty had 3 to 4 stratified cell layers covered with a distinctive umbrella cell layer. Strong uroplakin staining was visible in all cell layers except the basal layer. At the enterovesical and gastrovesical junctions 6 to 10 layers of hyperplastic, urothelial appearing cells covered the glandular epithelium of the ileal and gastric segments. These cells expressed uroplakins. At this junction zone there was a marked decrease of underlying enteric glands, which had atrophied in proportion to the degree of urothelial hyperplasia. Double staining of uroplakin stained sections with alcian blue and periodic acid-Schiff reagent revealed mucosubstances in hyperplastic urothelial cells covering the enteral segments, indicating that the cells co-expressed uroplakins and mucins.Conclusions: Histological changes in this experimental canine model of augmentation cystoplasty indicated that the overgrowth of hyperplastic transitional epithelium develops at the enterovesical and gastrovesical junctions. These cells express not only uroplakins, but also mucosubstances. Our results suggest that the migrated hyperplastic urothelial cells have undergone changes characteristic of the enteric and gastric epithelium, which may have important implications in the pathogenesis of malignancy in bladder augmentations.