Narrow Band Imaging Cystoscopy Improves the Detection of Non-muscle-invasive Bladder Cancer

被引:111
作者
Cauberg, Evelyne C. C.
Kloen, Sarah
Visser, Mike
de la Rosette, Jean J. M. C. H.
Babjuk, Marko
Soukup, Viktor
Pesl, Michael
Duskova, Jaroslava
de Reijke, Theo M.
机构
[1] Med Ctr, Dept Urol, Amsterdam, Netherlands
[2] Med Ctr, Dept Pathol, Amsterdam, Netherlands
[3] Charles Univ Prague, Gen Fac Hosp, Fac Med 1, Dept Urol, Prague, Czech Republic
[4] Charles Univ Prague, Gen Fac Hosp, Fac Med 1, Dept Pathol, Prague, Czech Republic
关键词
TRANSITIONAL-CELL CARCINOMA; PHOTODYNAMIC DIAGNOSIS; 7; EORTC; RECURRENCE; GRADE;
D O I
10.1016/j.urology.2009.11.075
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVES To determine whether narrow band imaging (NBI) improves detection of non-muscle-invasive bladder cancer over white-light imaging (WLI) cystoscopy. METHODS We conducted a prospective, within-patient comparison on 103 consecutive procedures on 95 patients scheduled for (re-) transurethral resection of a bladder tumor (84) or bladder biopsies (19) in the Academic Medical Center, Amsterdam (September 2007 - July 2009) and in the General Faculty Hospital, Prague (January 2009 - July 2009). WLI and NBI cystoscopy were subsequently performed by different surgeons who independently indicated all tumors and suspect areas on a bladder diagram. The lesions identified were resected/biopsied and sent for histopathological examination. Number of patients with additional tumors detected by WLI and NBI were calculated; mean number of urothelial carcinomas (UCs) per patient, detection rates, and false-positive rates of both techniques were compared. RESULTS A total of 78 patients had a confirmed UC; there were 226 tumors in total. In 28 (35.9%) of these patients, a total of 39 additional tumors (17.3%) (26pTa, 6pT1, 1pT2, 6pTis) were detected by NBI, whereas 4 additional tumors (1.8%) (1pTa, 1pT1, 2pTis) within 3 patients (2.9%) were detected by WLI. The mean (SD, range) number of UCs per patient identified by NBI was 2.1 (2.6, 0-15), vs 1.7 (2.3, 0-15) by WLI (P <.001). The detection rate of NBI was 94.7% vs 79.2% for WLI (P <.001). The false-positive rate of NBI and WLI was 31.6% and 24.5%, respectively (P <.001). CONCLUSIONS NBI cystoscopy improves the detection of primary and recurrent nonmuscle invasive bladder cancer over WLI. However, further validation of the technique with comparative studies is required. UROLOGY 76: 658-663, 2010. (c) 2010 Elsevier Inc.
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页码:658 / 663
页数:6
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