Changes in the number of cells and in the presence of cells with atypical nuclei in the epithelium of the urinary bladder appear to be associated with cigarette smoking, according to the authors of this study from the Veterans Administration Medical Center in East Orange, N.J., and the American Cancer Society.
Histologic examinations were performed in random order on 6,503 slides of urinary bladder epithelium obtained at autopsy from 282 subjects (70% men, 30% women) ranging in age from 10 to 94 years. History of smoking and of artificial sweetener use was obtained from family members of each subject.
Slides showing cells with 50% or more atypical nuclei were found in 4.3% of those who had never smoked regularly, in 67.2% who had smoked fewer than 20 cigarettes a day, in 72.2% who smoked 20 to 39 cigarettes a day, and in 88.4% who smoked 40 or more cigarettes a day.
An increase in the number of basal cell rows in the epithelium was also linked to the number of cigarettes smoked each day. Six or more cell rows were seen in 4.8% of sections from subjects who had never smoked, in 52.5% of those who smoked fewer than 20 cigarettes a day, in 62.5% of those who smoked 20 to 39 cigarettes a day, and in 72.9% who smoked 40 or more cigarettes a day. In a small sample of sections from 95 former smokers and 22 pipe or cigar smokers, the percentage increase in cells with atypical nuclei and in sections with an increased number of cell rows was higher in this group of subjects than in non-smokers, but lower than in smokers.
The authors also found cystitis cystic in specimens from 20.6% of non-smokers, as compared with 5% of smokers, a statistically significant different that was not related to the other changes that were observed.