Bryan Richard T, Billingham Lucinda J, Wallace D Michael A
Department of Public Health and Epidemiology, University of Birmingham, Birmingham, UK.
BJU Int. 2008 Mar;101(6):702-5; discussion 705-6. doi: 10.1111/j.1464-410X.2007.07317.x. Epub 2007 Nov 13.
To investigate whether narrow-band imaging (NBI) flexible cystoscopy improves the detection rate of urothelial carcinomas (UCs) of the bladder. NBI is an optical image enhancement technology in which the narrow bandwidth of light is strongly absorbed by haemoglobin and penetrates only the surface of tissue, increasing the visibility of capillaries and other delicate tissue surface structures by enhancing contrast between the two.
Between November 2005 and May 2007 at the Queen Elizabeth Hospital, Birmingham, NBI flexible cystoscopy was performed on 29 patients with known recurrences of UC of the bladder after initial conventional white-light imaging (WLI) flexible cystoscopy with the same instrument (Olympus Lucera sequential RGB endoscopy system).
Subjectively, NBI provided a much clearer view of bladder UCs and in particular their delicate capillary architecture. Objectively, NBI detected 15 additional UCs in 12 of 29 patients (41%), as compared with WLI. The mean (sd) difference was 0.52 (0.74) UCs per patient (P < 0.001, Wilcoxon signed-rank test).
Even in the few patients studied there is strong evidence that NBI differs from WLI in the number of UCs it detects, with a significantly increased detection rate. We feel that further evaluation of NBI flexible cystoscopy in more patients will show this technique to be highly valuable in the detection of both new and recurrent bladder UCs, and this work is continuing in our unit.
研究窄带成像（NBI）软性膀胱镜检查能否提高膀胱尿路上皮癌（UC）的检出率。NBI是一种光学图像增强技术，其窄带光被血红蛋白强烈吸收，仅穿透组织表面，通过增强两者之间的对比度来提高毛细血管和其他精细组织表面结构的可见性。
2005年11月至2007年5月期间，在伯明翰伊丽莎白女王医院，对29例已知膀胱UC复发的患者进行了NBI软性膀胱镜检查，这些患者最初使用同一台仪器（奥林巴斯Lucera序贯RGB内镜系统）进行了传统白光成像（WLI）软性膀胱镜检查。
主观上，NBI能更清晰地显示膀胱UC，尤其是其精细的毛细血管结构。客观上，与WLI相比，NBI在29例患者中的12例（41%）中又检测出15处UC。每位患者检测出的UC数量平均（标准差）差异为0.52（0.74）处（P<0.001，Wilcoxon符号秩检验）。
即使在少数研究患者中，也有强有力的证据表明NBI在检测出的UC数量上与WLI不同，其检出率显著提高。我们认为，对更多患者进行NBI软性膀胱镜检查的进一步评估将表明，该技术在检测新发和复发性膀胱UC方面具有很高的价值，我们科室正在继续这项工作。
