Do Orthotopic Ileal Diversions Induce Immunological Changes in Retained Urethral Tissue

摘要: Background A second primary tumors of the urethra (urethral recurrence) after radical cystectomy has been reported to be more infrequent in patients with ileal orthotopic (neobladder) compared incontinent diversions. Objective To investigate whether an altered immunogenic environment urethral tissue is induced by urethro-ileal anastomosis. Methods Between 10/2008 and 12/2009 biopsies 19 (9 neobladder patients, 10 control without urethra-ileal anastomosis) were evaluated conventional histopathological examination immunohistochemistry for T- (CD3/CD5, CD4, CD8) B-cell markers (CD20/22, CD79a, CD138). After semi-quantitative assessment, relative cell fractions (B vs. T cells) subclasses (T4-helper T8-killer cells B clones, plasma studied. Unpaired t-test was used statistical analysis. Results Of included 16 eligible analysis (7x neobladder, 9x controls). All had undergone UBC. Comparing positive NB CO no differences observed. In 4/7 fraction CD79a B-cells higher than CD3/CD5 T-cells (B/T-ratio 1.3). predominantly CD138 (5/7 patients). Relative lower T-cell 7/9 0.6). Neither CD 138 nor CD22 clones predominant. T-helper CD8 T-killer equally distributed both (CD4/CD8-ratio: 2.1) 1.9). Conclusions neobadder distribution B- statistically not different. However, a trend towards increased presence tissues that could become relevant larger study might suggestive immunological response connecting tissue.