The ultrastructural pathological change and clinical significance of vesical leukoplakia lesions at different areas

Abstract

Objective To investigate the uhrastruchural pathological change and clinical signifi-cance of veaical leukoplakia lesions at different areas. Methods We randomly selected 80 cases/times of the mucosa in central area of vesical leakoplakia,and 89 cases/times of the mucosa located respectively in marginal area of vesical ieukoplakia and 1. 0,2.0,2.5 cm away from the marginal area of vesical leukopla- kia. The mucoea in all cases was examined using the electron microscope by double blind method to study the ultrastructural characteristics m different areas of vesical leakoplakia lesions, and then compared with the ultrastructure of normal bladder mucosa from non-vesical leukoplakia. Results There were early path-ologica] changes in para-leaukoplasia areas that found by cystoscope. From 2 cm away from the marginal area of vesical leukoplakia to center of the lesions, the covering epithelia were altered gradually from transi-tional epithelia to interphase of transitional and squamous epithelia, squamous metaplusia, keratinizing squnmous metaplasia. The basement membrane of the epithelia was transformed gradually from flat to curved. Four types of, including 5 kinds,typical uhrastructural features in lesion areas could be seen. There were 5 eases of tpye 0 Ⅰ ,8 cases of type 0 Ⅱ , 12 cases of type Ⅰ ,42 cases of type Ⅲ ,and 13 cases of type Ⅲ in 80 central areas of vesical]eukoplakia. Conclusion According to the ultmstructural changes,lesion of vesical leukoplakia could be divided into 4 types,namely type 0(type 0 Ⅰ ,type 0 Ⅱ),tpye Ⅰ,type Ⅱ and type Ⅲ. This classification could help us to better understand the process of occurrence and develop- ment of vesical ieukoplakia, and it has also important value in the diagnosis of vesical leukoplakia and the selecfion of therapeutic methods for this disease. Key words: Vesieal leukoplakia; Ultrastrueture ; Classification