Department of Urology, China PLA General Hospital, Beijinig, P.R. China.
Urol Oncol. 2013 May;31(4):475-9. doi: 10.1016/j.urolonc.2011.02.009. Epub 2011 Nov 12.
To investigate the value of narrow-band imaging (NBI) flexible cystoscopy in the detection of urothelial carcinoma (UC) of the bladder.
Clinical data of 179 patients with suspected UC, who presented with gross hematuria, were collected at China PLA General Hospital from January 2009 to August 2010. These patients underwent white-light imaging (WLI) cystoscopy followed by NBI. The tumors were visualized, imaged, and recorded. Suspected UCs were biopsied or treated by transurethral resection, and then sent for pathologic examination. Detection results for NBI and WLI were compared.
WLI and NBI confirmed UC in 143 patients; a total of 285 tumors were detected. The patient-level detection rates for NBI and WLI were 97.9% (140/143) and 88.8% (127/143), respectively (P = 0.002). The patient-level false-positive detection rates for NBI and WLI were 21.8% (39/179) and 29.1% (52/179), respectively (P = 0.12). NBI detected a total of 59 additional tumors (17.2%; 34pTa, 17pT1, 3pT2, and 5pTis) in 44 of 143 patients (30.8%). NBI found 1 additional tumor in 34 cases, 2 additional tumors in 6 cases, 3 additional tumors in 3 cases, and 4 additional tumors in 1 case. The mean ± SD (range) number of identified UCs per patient was 1.97 ± 0.67 (1-5) for NBI and 1.78 ± 0.53 (1-4) for WLI (P = 0.01). The tumor-level detection rates for NBI and WLI were 96.8% and 79.3%, respectively (P < 0.001).
Compared with WLI, NBI improves UC detection. It has a higher rate of detection and a comparative rate of false-positive detection. NBI is simple and requires no dyeing. It can be conveniently applied to complement WLI.
探讨窄带成像（NBI）软镜在膀胱尿路上皮癌（UC）检测中的价值。
回顾性分析 2009 年 1 月至 2010 年 8 月在中国人民解放军总医院就诊，因肉眼血尿行白光成像（WLI）膀胱镜检查后行 NBI 检查的 179 例可疑 UC 患者的临床资料。观察、记录肿瘤并对可疑 UC 行活检或经尿道电切术，术后送病理检查。比较 NBI 与 WLI 的检测结果。
WLI 和 NBI 共确诊 UC 患者 143 例，共发现 285 个肿瘤。NBI 和 WLI 的患者级检出率分别为 97.9%（140/143）和 88.8%（127/143）（P=0.002），假阳性率分别为 21.8%（39/179）和 29.1%（52/179）（P=0.12）。NBI 共在 44 例患者（30.8%）中发现 59 个额外肿瘤（34 个 Ta、17 个 T1、3 个 T2 和 5 个Tis）。NBI 发现 1 个额外肿瘤的患者 34 例，发现 2 个额外肿瘤的患者 6 例，发现 3 个额外肿瘤的患者 3 例，发现 4 个额外肿瘤的患者 1 例。NBI 与 WLI 每位患者检出肿瘤的平均数分别为 1.97±0.67（15）和 1.78±0.53（14）（P=0.01）。NBI 和 WLI 的肿瘤级检出率分别为 96.8%和 79.3%（P<0.001）。
与 WLI 相比，NBI 可提高 UC 的检出率，其检出率更高，假阳性率相似。NBI 操作简单，无需染色，可方便地与 WLI 互补。
