Swinn M J, Walker M M, Harbin L J, Adshead J M, Witherow R O'N, Vale J A, Patel A
Department of Urology, Imperial College London, St Mary's Campus, Norfolk Place, London W2 1PG, UK.
Eur Urol. 2004 Apr;45(4):471-4; discussion 474. doi: 10.1016/j.eururo.2003.11.019.
At cystoscopy red patches of urothelium are commonly seen within the bladder and frequently biopsied in order to exclude carcinoma in situ (CIS), which classically presents as a red, velvety patch. This appearance however is not specific and it is possible that many lesions are biopsied without significant benefit to the patient. The objective of this study was to determine whether routine biopsy of red patches seen in the bladder at cystoscopy is warranted.
193 biopsies were taken from red patches seen at flexible and rigid cystoscopy during a 4-year period from December 1997 to January 2002 and examined by histopathology. Patients included in the study were those on cystoscopic follow-up for transitional cell carcinoma (TCC) of the bladder and those undergoing investigation for haematuria or lower urinary tract symptoms.
In 193 (17.7% of total biopsies) red patch biopsies, malignancy was found in 23 (11.9%) and 18 of 23 (78.3%) were CIS. No malignancies were detected in red patches from patients under the age of 60 years.
Red patch biopsy yields a positive finding of malignancy in 12% and was concluded to be a valuable exercise, particularly in those over the age of 60 years and on follow-up for TCC.
在膀胱镜检查中，膀胱内常见红色尿路上皮斑块，常对其进行活检以排除原位癌（CIS），原位癌典型表现为红色天鹅绒样斑块。然而，这种表现并不具有特异性，许多病变进行活检可能对患者并无显著益处。本研究的目的是确定膀胱镜检查时所见膀胱红色斑块进行常规活检是否必要。
在1997年12月至2002年1月的4年期间，对在软性和硬性膀胱镜检查中发现的红色斑块进行了193次活检，并进行了组织病理学检查。纳入研究的患者包括膀胱移行细胞癌（TCC）膀胱镜随访患者以及因血尿或下尿路症状接受检查的患者。
在193次（占活检总数的17.7%）红色斑块活检中，发现恶性病变23例（11.9%），其中23例中有18例（78.3%）为原位癌。60岁以下患者的红色斑块未检测到恶性病变。
红色斑块活检的恶性病变阳性率为12%，得出结论认为这是一项有价值的检查，特别是对于60岁以上且正在接受TCC随访的患者。
