BLADDER WALL ABNORMALITIES IN MYELODYSPLASTIC BLADDERS - A COMPUTER-ASSISTED MORPHOMETRIC ANALYSIS
BLADDER WALL ABNORMALITIES IN MYELODYSPLASTIC BLADDERS - A COMPUTER-ASSISTED MORPHOMETRIC ANALYSIS
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DOI：
10.1016/s0022-5347(17)38521-x
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发表时间：
1991-05-01
影响因子：
6.6
通讯作者：
LEPOR, H
中科院分区：
文献类型：
--
作者：
SHAPIRO, E;BECICH, MJ;LEPOR, H
骨髓增生异常是儿童神经源性膀胱功能障碍的最常见原因。先前尚未描述与骨髓增生异常膀胱相关的特定组织学特征。我们的目标是在自动图像分析系统的帮助下，使用经典形态测量分析来研究对照膀胱和骨髓增生异常膀胱中平滑肌和结缔组织之间的关系。对正常死产胎儿膀胱标本的大体组织学分析显示，有组织的肌束嵌入少量结缔组织中。脊髓脊膜膨出死胎的膀胱标本显示肌束明显缺乏，并且肌束尺寸显着减小。从接受尸检的患者和接受膀胱扩大成形术的患者获得的脊髓脊膜膨出膀胱标本显示，致密结缔组织对平滑肌有明显的束间和细胞周浸润。定量形态分析表明，与对照死产胎儿相比，脊髓脊膜膨出死产胎儿的结缔组织体积含量显着增加。与正常对照组相比，接受尸检或膀胱扩大成形术的脊髓脊膜膨出患者的膀胱中结缔组织增加了3倍。这些发现表明，骨髓增生异常性膀胱的组织学成分的结构变化不仅可以在接受尸检或膀胱扩大成形术的不同年龄的患者中得到证实，而且可以在发育中的胎儿中得到证实。这些发现增强了我们对骨髓增生异常膀胱中结缔组织增殖与平滑肌关系的理解。我们讨论这些发现与病理性逼尿肌形态和逼尿肌功能障碍的关系。
Myelodysplasia represents the most common cause of neurogenic bladder dysfunction in children. The specific histological features associated with myelodysplastic bladders have not been previously characterized. Our objective was to study the relationship between smooth muscle and connective tissue in control and myelodysplastic bladders using classical morphometric analysis with the assistance of an automated image analysis system. Gross histological analysis of the bladder specimens of normal stillborn fetuses showed organized muscle bundles embedded in a small amount of connective tissue. The bladder specimens of myelomeningocele stillborn fetuses showed a marked paucity of muscle bundles as well as a significantly diminished size of the muscle bundles. The myelomeningocele bladder specimens obtained from patients undergoing autopsy and those undergoing augmentation cystoplasty revealed significant interfascicular and pericellular infiltration of the smooth muscle by dense connective tissue. Quantitative morphometric analysis showed that the myelomeningocele stillborn fetuses have a significant increase in the volumetric content of connective tissue compared to control stillborn fetuses. The bladders of myelomeningocele patients who underwent autopsy or augmentation cystoplasty had a 3-fold increase in connective tissue when compared to normal controls.These findings reveal that structural changes in the histological components of the myelodysplastic bladder can be demonstrated not only in patients of varying ages undergoing autopsy or augmentation cystoplasty but also in the developing fetus. These findings enhance our understanding of the relationship of connective tissue proliferation to smooth muscle in the myelodysplastic bladder. We discuss the relationship of these findings to pathological detrusor morphology and detrusor dysfunction.