Herr Harry W, Donat S Machele
Department of Urology, Memorial Sloan-Kettering Cancer Center, Weill Cornell Medical College, New York, NY 10021, USA.
BJU Int. 2008 Nov;102(9):1111-4. doi: 10.1111/j.1464-410X.2008.07846.x. Epub 2008 Sep 3.
To determine whether narrow-band imaging (NBI) cystoscopy enhances the detection of non-muscle-invasive bladder tumours over standard white-light imaging (WLI) cystoscopy, as surveillance WLI is the standard method used to diagnose patients with recurrent bladder tumours, but they can be missed by WLI cystoscopy, possibly accounting for early recurrences.
We evaluated 427 patients for recurrent bladder tumours by WLI cystoscopy, followed by NBI cystoscopy as a further procedure, using the same video-cystoscope. Recurrent tumours visualized by WLI or NBI cystoscopy were mapped, imaged, biopsied and subsequently treated by transurethral resection (TUR) or fulguration. Biopsies or TUR specimens obtained by WLI and NBI were examined separately for presence of tumour.
In all, 103 patients (24%) had tumour recurrences; 90 (87%) were detected by both WLI and NBI and another 13 (100%) only by NBI cystoscopy. NBI detected extra papillary tumours or more extensive carcinoma in situ in 58 (56%) patients found to have recurrences. The mean number of recurrent tumours visualized on WLI cystoscopy was 2.3, vs to 3.4 seen on NBI cystoscopy (P = 0.01).
NBI cystoscopy improved the detection of recurrent non-muscle-invasive bladder tumours over standard WLI cystoscopy.
确定窄带成像（NBI）膀胱镜检查相对于标准白光成像（WLI）膀胱镜检查是否能增强对非肌层浸润性膀胱肿瘤的检测。因为监测性WLI是用于诊断复发性膀胱肿瘤患者的标准方法，但WLI膀胱镜检查可能会漏诊这些肿瘤，这可能是早期复发的原因。
我们使用同一台视频膀胱镜，先通过WLI膀胱镜检查评估427例复发性膀胱肿瘤患者，然后再进行NBI膀胱镜检查。对WLI或NBI膀胱镜检查发现的复发性肿瘤进行定位、成像、活检，随后行经尿道切除术（TUR）或电灼治疗。分别检查通过WLI和NBI获取的活检或TUR标本中是否存在肿瘤。
总共103例患者（24%）出现肿瘤复发；90例（87%）通过WLI和NBI均检测到，另外13例（100%）仅通过NBI膀胱镜检查检测到。在58例（56%）发现有复发的患者中，NBI检测到额外的乳头状肿瘤或更广泛的原位癌。WLI膀胱镜检查发现的复发性肿瘤平均数量为2.3个，而NBI膀胱镜检查发现为3.4个（P = 0.01）。
与标准WLI膀胱镜检查相比，NBI膀胱镜检查提高了对复发性非肌层浸润性膀胱肿瘤的检测能力。
