BCG对膀胱粘膜结构的影响及肿瘤超微病理的研究

The effect of intravesical BCG instillation on the mucosal architecture of bladder and the ultrastructure of tumor cells

应用光镜、透射电镜与扫描电镜技术对２０例浅表膀胱肿瘤ＢＣＧ治疗前后粘膜结构，肿瘤超微结构及Ｈｅｌａ细胞表面结构的影响作了比较研究。结果表明，ＢＣＧ灌注后，膀胱粘膜的结构发生了明显的改变，粘膜层次变薄，粘膜下可见大量单个核细胞浸润，肉芽肿与非干酪样淋巴细胞团形成。ＢＣＧ与肿瘤细胞直接作用后，其表面结构的损伤程度与ＢＣＧ的浓度和时间呈一致性变化。ＢＣＧ浓度组中均可见ＢＣＧ与肿瘤细胞表面结构紧密附着。ＢＣＧ灌注后６例残留瘤细胞的超微结构可见不同程度的损伤；肿瘤细胞连接开放，细胞间隙，光面与粗面内质网扩张。细胞器肿胀或空泡样变，细胞核固缩，肿瘤细胞间可见淋巴细胞浸润，相邻细胞发生严重变性。就ＢＣＧ对粘膜结构的改变，肿瘤超微结构及表面结构的损伤机理与临床意义进行了讨论。

The effect of intravesical instillation of BCG on the mucosal architecture and the ultrastructure of tumor cell was studied by light and electron microscopy in 20 cases of superficial bladder tumor.marked changs in mucosa were observed.It became thinner with abundant monocyte infiltration in the submucosa. Evident granuloma and noncaseating lymphocyte masses were observed. In 6 cases,ultrastructural changs of the tumor cells could be observed and became marked 24￣48 hours after BCG instillation. Injury to the tumor cells was directly related to the BCG concentration and the duration of contact.It was postulated that direct cytotoxic effect of BCG on the tumor cells,in addition to its cell mediated local immune effect,might play a significant role in its antitumor mechanism..