Dalbagni G, Rechtschaffen T, Herr H W
Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
J Urol. 1999 Sep;162(3 Pt 1):708-9. doi: 10.1097/00005392-199909010-00020.
We assessed the need for transurethral biopsy of the bladder at the 3-month evaluation in patients who have received intravesical bacillus Calmette-Guerin (BCG).
A total of 81 patients collectively received 83, 6-week courses of BCG between 1995 and 1997, and underwent transurethral bladder biopsies 3 months after initiation of immunotherapy. The pretreatment and posttreatment bladder biopsy results, urinary cytology and posttreatment cystoscopic findings were correlated.
Transitional cell carcinoma was demonstrated in 5 of 11 patients with erythematous bladder mucosa and a positive cytology compared to none of 37 with an erythematous lesion and a negative cytology. Of 12 patients with a papillary lesion on cystoscopy and a positive biopsy 10 had a negative cytology, and only 1 of 13 patients with a negative cystoscopy had a positive biopsy.
Bladder biopsy is not necessary in patients 3 months after receiving BCG who have a normal office cystoscopy or an erythematous bladder and normal urine cytology.
我们评估了接受膀胱内卡介苗（BCG）治疗的患者在3个月评估时经尿道膀胱活检的必要性。
1995年至1997年间，共有81例患者共接受了83个6周疗程的BCG治疗，并在免疫治疗开始3个月后接受了经尿道膀胱活检。将治疗前和治疗后的膀胱活检结果、尿液细胞学检查结果和治疗后的膀胱镜检查结果进行相关性分析。
11例膀胱黏膜红斑且细胞学检查阳性的患者中有5例被诊断为移行细胞癌，而37例有红斑病变且细胞学检查阴性的患者中无一例被诊断为移行细胞癌。膀胱镜检查发现乳头状病变且活检阳性的12例患者中，10例细胞学检查阴性，膀胱镜检查阴性的13例患者中只有1例活检阳性。
接受BCG治疗3个月后，膀胱镜检查正常或膀胱有红斑且尿液细胞学检查正常的患者无需进行膀胱活检。
