Ultrastructural diagnostic markers of the urinary bladder precancer

A morphological analysis of 346 biopsy specimens from 140 patients with chronic cystitis permits one to evaluate the proliferative forms of the disease, the cases with atypical hyperplasia of the urothelium or metaplasia of the squamous cells with acanthosis and hyperkeratosis of the group at risk, belonging to bladder precancer. The early ultrastructural signs of urothelial atypia are determined, among them the thickening of the glycocalyx layer (up to 30-60 nm) irregularly covering the entire surface of atypical cells, the disappearance of vesicular apparatus and AUM, the widening of the intercellular spaces. It was found that the squamous epithelium, formed by atypical cytodifferentiation of urothelium, is inadequate for performing the barrier function inherent in normal urothelium.