膀胱白斑的电切镜下表现及病理特点

Electrotomoscopy and pathological characteristics of vesicalleukoplakia

目的 探讨膀胱白斑的电切镜下表现及病理特点 ,为临床诊断、治疗提供可靠依据。方法 随机对门诊 43 6例患者用电切镜进行膀胱尿道镜检和病灶活检 ,发现膀胱白斑 68例 ,观察膀胱白斑 ,取病灶组织活检 ,观察病理变化。结果 电切镜下膀胱白斑为白色不规则稍隆起白色斑片状 ,多见于膀胱三角区。病检所见膀胱白斑为膀胱黏膜鳞状上皮化生 ,并有活跃的细胞角化。 68例中增生型 65例 ,增生、萎缩混合型 3例。合并腺性膀胱炎 2 3例。固有膜炎性浸润 3 6例。细胞增生活跃、排列紊乱、有异形性 9例 ,合并移行细胞癌Ⅰ级 1例。合并膀胱颈部炎性息肉 13例 ,慢性滤泡性膀胱炎 1例 ,发现结石或结晶 6例 ,可见出血灶 7例。结论 膀胱白斑是较常见的膀胱黏膜变异现象 ,可能为癌前病变 ,常与慢性膀胱炎、腺性膀胱炎等合并存在 ,用电切镜检查较易发现 ,及时取病灶组织活检对早期确诊具有重要意义。

Objective To study the electrotomoscopy and pathological characteristics of vesical leukoplakia to provide reliable basis for the clinical diagnosis and treatment.Methods Sixty-eight cases of vesical leukoplakia were detected in 436 patients at radomn by means of electrotomoscopic biopsy of suspicious foci in bladder.The pathological paraffin-embedded sections of suspicious foci were examined by hematoxylin-eosin staining to study the pathological changes.Results Under the electrotomoscope,vesicale bladder biopsy of the leukoplakia showed squamous epithelium with active keratinisation.Of the 68 cases,65 had the hypertrophic type of leukoplakia while 3 had hypertrophic and atrophic type.Twenty-three cases were complicated by glandular cystitis.Thirty-six were complicated by inflammatory infiltration in lamina propria of bladder.Nine showed active cell hyperplasia,disorders and atypia,one was complicated by transitional cell carcinoma I.Thirteen had inflammatory polypus at the bladder neck,one was complicated by chronic cystitis follicularis.Calculus or crystal was found in 6 cases.Seven cases had bleeding foci.Conclusion Vesical leukoplakia is a common variation of bladder mucus,probably precancerous lesion.It often exists with chronic cystitis,glandular cystitis,etc.It is found easily by the electrotomoscopy.Biopsy of the suspicious foci in time is very important for early diagnosis.