間質性膀胱炎之臨床症狀與膀胱上皮厚度的相關性
李建達1,2、李明輝1,2、陳韋志1
1 衛生福利部豐原醫院 泌尿科； 2 中台科技大學
Clinical symptoms associated with urothelial thickness of bladder in patients with interstitial cystitis / bladder pain syndrome (IC/BPS)
Jane-Dar Lee1,2 , Ming-Huei Lee1,2, Wei-Chih Chen1
1 Divisions of Urology, Feng-Yuan Hospital, Taichung, Taiwan
2 Central Taiwan University of Science
Purpose: Recent studies showed that increased apoptosis and denudation/thinning of the bladder urothelium are common findings in IC/BPS patients. Thus, the aim of our study is to investigate the relationship between bladder urothelial thickness and clinical symptoms of IC/BPS patients
Materials and Methods: The study group consisted of 30 patients with IC/BPS and the control group consisted of 12 volunteers without any IC/BPS symptoms. Bladder biopsies were taken from both groups. We determined the thickness of the bladder urothelium by immunohistochemical staining for CK7 (cytokeratin 7; an epithelial marker). The five symptom questionnaire including visual pain analogue scale (VAS-pain scale), visual urgency analogue scale (VAS-urgency scale), O’Leary-Sant Symptom Index (ICSI), O’Leary-Sant Problem Index (ICPI), and Pain and Urgency / Frequency symptom scale (PUF scale) were also recorded. The pain score of KCL Test was also performed. We analyzed the correlation between bladder urothelial thickness and clinical symptoms by using Spearman's rho.
Results: The thickness of bladder urothelium was significantly decreased in the IC/BPS group as compared with that in the control group, as revealed by the CK7 stain measurement (about 26 μm vs. 50 μm). We divided IC/BPS group into two groups, thinner group and thicker group, by using urothelial thickness. There is negative correlation between urothelial thickness and VAS-urgency scale & PUF scale in thinner group. Moreover, the thinner urothelial thickness is statistically association with the increased pain score of KCL test in thicker group.
Conclusions: The bladder urothelial thickness was significantly decreased (approximately 50% less) in the IC/BPS group compared with that in the control group. In patients with IC/BPS, urothelial thickness was correlated significantly with clinical symptoms in both thicker and thinner urothelial thickness groups.