[Morphofunctional changes in the bronchial epithelium in combined therapy for lung cancer]

Morphofunctional changes in the bronchial mucosa were studied in 33 patients with stage 3 lung cancer. The patients underwent intraoperative radiation therapy (IORT) in a dose of 15 Gy, using cisplatine as a radiosensitizer. No degenerative changes in the bronchial epithelium were found 2 weeks after IORT. Basal cell proliferation was observed, goblet cells were reduced in size and the basement membrane was thickened and twisted. Epithelial reparation due to pronounced local basal cell proliferation was observed 3 months later. A year later, the mucosa was covered with the multinuclear cylindrical epithelium and the cover of ciliated cells was preserved. The functional activity of goblet cells was in the normal range and scanty lymphoplasmocytic infiltration was found in the stroma. With IORT without radiosensitization, the damaged epithelium was regenerated due to the reserved cells coming from the damaged margins with the formation of an epidermoid regenerative layer and subsequent cell differentiation. Moderate sclerosis occurred in the stroma. A year later the bronchial epithelium was characterized by moderate goblet cell hyperplasia with preserved functional activity. Thus, IORT caused mucosal damage as alteration, dystrophy, and desquamation of the epithelium. Subsequently, the bronchial epithelium recovered through reparative regeneration.