[The epidemiology and importance of metaplasia and dysplasia of the urinary bladder mucosa in autopsy material from a middle-size industrial city (study of Görlitz)].

Abstract

This study had been conducted for the purpose of obtaining information on incidence and biological significance of metaplasia and dysplasia of the urinary bladder. Therefore, postmortem investigations were made of 1,117 urinary bladders, using optical light microscopy and mapping. They were related to a medium-size industrial town with an autopsy frequency of 98%. Metaplasia (58%) and dysplasia (13%) are no rare urinary bladder findings and occur particularly to individuals in somewhat advanced age, with no significant sex-related difference. Urocystitis was recorded from over 50% of all cases reviewed. More strongly pronounced inflammatory processes appeared to be risk factors for higher severity of dysplasia. Inconspicuous as well as metaplastic von Brunn's nests or squamous and glandular metaplasia without atypical cells should not be considered precarcinomas. However, atypical cells in terms of dysplasia were recordable from a small number of these metaplasias. Precancerous importance might be attributed to few of them, particularly in male patients with dysplastic squamous cell metaplasia. No reliable information, however, was available on premature development of dysplasia in lower age groups which would have meant a long-drawn process of carcinogenesis.