窄带显像膀胱镜在复发性膀胱肿瘤诊断中的应用

The application of narrow-band imaging cystoscopy in diagnosis of recurrent bladder cancer

摘要:

目的 探讨窄带显像膀胱镜在膀胱肿瘤诊断中的应用价值。 方法 对461例临床膀胱肿瘤可疑诊断患者行窄带显像膀胱镜检查，根据活检结果分析窄带显像膀胱镜在膀胱肿瘤诊断中的应用价值。 结果 2009年1月~2011年3月，该科行窄带显像膀胱镜检查共461例，共对243人次患者行窄带显像膀胱镜引导下活检468例次，病理结果提示：共发现膀胱肿瘤病变214例次，良性病变254例次。其中初发膀胱肿瘤100人次，共发现病变193例次，其中肿瘤病变153例次，良性病变40例次，共3人次8例病变仅在NBI下可见，其中肿瘤病变3例，良性病变5例，其余病变在NBI和WLI下均可见。复发膀胱肿瘤27人次，共发现病变80例次，其中肿瘤病变61例次，良性病变19例次，其中6人21例次病变仅在NBI下可见，WLI下不可见，6人10例次为肿瘤病变，4人11例次良性病变。未发现在WLI下可见而NBI下不可见病例。116人次行随机活检，共发现195例次病变，均为良性病变。 结论 窄带显像膀胱镜可发现更多白光膀胱镜不能发现的复发性膀胱肿瘤病变。窄带显像膀胱镜在膀胱肿瘤的复发和随访监测中有应用价值。

Abstract:

【Objective】 To investigate narrow-band imaging (NBI) cystoscopy in the detection of bladder cancer. 【Methods】 Patients received white light imaging (WLI) cystoscopy first then NBI cystoscopy. Biopsy was done in narrow band imaging mode and rechecked in white light and NBI mode. 【Results】 468 biopsies by narrow-band imaging cystoscopy were carried out in 243 cases . A total of 468 lesions were harvested. 113 patients with 214 lesions were confirmed bladder transitional cell carcinoma by pathologist.For primary bladder tumors, 100 patient with 193 lesions were founded, 153 lesions were confirmed as bladder transitional cell carcinoma. For recurrent bladder tumors, 27 patients with 80 lesions were founded, 61 lesions were bladder transitional cell carcinoma. NBI cystoscopy detected additional 10 tumor lesions in 6 patients compared with WLI cystoscopy. No lesions could be found by WLI cystoscopy while overlooked by NBI cystoscopy. 【Conclusion】 Compared with WLI cystoscopy, NBI cystoscopy increases the detection rate of recurrent bladder cancer .