Diorio Gregory J, Canter Daniel J
Einstein Healthcare Network, Philadelphia, Pennsylvania, USA.
Can J Urol. 2015 Apr;22(2):7763-6.
For patients with non-muscle invasive bladder cancer, cystoscopy and transurethral resection/vaporization of the bladder tumor plays an integral role in the treatment of a given patient's bladder cancer. Although considered the current gold standard for tumor detection, traditional or white light cystoscopy has been shown to have its limitations visualizing both small papillary tumors and/or carcinoma in-situ. Current efforts have been directed to closing this gap with data demonstrating that by identifying these previously missed lesions, tumor recurrence and progression rates are reduced, thereby improving patient outcomes. Narrow Band Imaging, which can be used during cystoscopy and transurethral resection/vaporization of bladder tumors, can aid in visualizing mucosal and sub-mucosal hypervascularity--a probable surrogate for malignant lesions--potentially visualizing the boundaries of lesions that may have been missed during white light cystoscopy alone. This technique may produce equivalent visual markers with fewer logistical hurdles than currently available methods. In this article, we detail our technique for the adjunctive use of Narrow Band Imaging during cystoscopy and transurethral resection/vaporization of bladder tumors to aid in visualizing mucosal and sub-mucosal hypervascularity. Although not yet readily adopted, Narrow Band Imaging may be a practical and easy to use adjunct to existing methods in visualizing occult bladder lesions.
对于非肌层浸润性膀胱癌患者，膀胱镜检查及经尿道膀胱肿瘤切除术/汽化术在特定患者膀胱癌的治疗中起着不可或缺的作用。尽管传统的白光膀胱镜检查被认为是目前肿瘤检测的金标准，但已表明其在观察小乳头状肿瘤和/或原位癌方面存在局限性。目前的研究致力于缩小这一差距，有数据表明，通过识别这些先前漏诊的病变，可降低肿瘤复发率和进展率，从而改善患者预后。窄带成像可在膀胱镜检查及经尿道膀胱肿瘤切除术/汽化术中使用，有助于观察黏膜和黏膜下血管增多——这可能是恶性病变的一个替代指标——有可能观察到仅通过白光膀胱镜检查可能漏诊的病变边界。与现有方法相比，该技术可能产生同等的视觉标记且后勤障碍更少。在本文中，我们详细介绍了在膀胱镜检查及经尿道膀胱肿瘤切除术/汽化术中辅助使用窄带成像以观察黏膜和黏膜下血管增多的技术。尽管尚未被广泛采用，但窄带成像可能是一种实用且易于使用的辅助手段，可用于观察隐匿性膀胱病变的现有方法中。
