Sestre Milosrdnice University hospital and Institute of Clinical Medical Research
Abstract
The aim was to investigate stromal reaction, including inflammation and stromal desmoplasia in in situ and invasive urothelial carcinoma of urinary bladder and to determine the possible value of reactive stromal changes in the diagnosis of lamina propria invasion. We analyzed specimens from 24 consecutive patients with synchronous in situ and invasive urothelial carcinoma in the same biopsy. Specimens were obtained by transurethral resection, fixed and routinely stained with H&E and Mallory method. Immunohistochemistry was performed by monoclonal antibodies to vimentin, smooth muscle actin and desmin. The intensity of immunostaining was graded semiquantitatively on a scale of 0-3, and expressed as 0 = 0%; 1 = up to 33%; 2 = more than 33% to 66%; and 3 = more than 66% of positive stromal cells. The intensity of inflammation was labeled as 0 = no inflammation, 1 = weak, 2 = moderate, and 3 = dense inflammatory reaction. Mallory trichrome method showed predominantly no staining or weak green staining in 14/24 invasive and 20/24 in situ urothelial carcinomas (p>0.05). There was statistically significantly increased vimentin and smooth muscle actin immunostaining in the stroma of invasive carcinoma as compared with in situ carcinoma (p0,05). Utvrđena je statistički značajno jača reakcija na vimentin i glatkomišićni aktin u stromi invazivnih karcinoma u odnosu na karcinom in situ (p<0,05). Upalna reakcija je bila statistički značajno jača u invazivnim karcinomima (p<0,05). Imunohistokemijska izraženost miofibroblastičnih biljega bila je statistički značajno jača u invazivnim urotelnim karcinomima. Ovakvi rezultati mogu pomoći u dijagnozi invazije lamine proprije u invazivnom karcinomu mokraćnog mjehura
