Department of Urology, Korea University College of Medicine, Seoul, Korea.
Investig Clin Urol. 2018 Mar;59(2):98-105. doi: 10.4111/icu.2018.59.2.98. Epub 2018 Feb 8.
The purpose of this study was to evaluate the efficacy of narrow-band imaging (NBI) as a diagnostic tool for detecting bladder tumors during cystoscopy compared with white light cystoscopy (WLC).
From December 2013 to June 2017, a randomized prospective study was conducted on 198 patients underwent transurethral resection of bladder tumor by a single surgeon. The patients were divided into two groups according to diagnostic method. In Group I, WLC only was performed. In Group II, NBI was additionally performed after WLC. We analyzed the rate of detection of bladder tumors as a primary endpoint. In addition, we evaluated rates of recurrence in each group.
There were no significant differences between the two groups in characteristics except hypertension. In the analysis of rates of detection, the probability of diagnosing cancer was 80.9% (114/141) in the WLC group, and the probability of diagnosing cancer using WLC in the NBI group was 85.5% (159/186). After switching from WLC to NBI for second-look cystoscopy in the NBI group, NBI was shown to detect additional tumors with a detection rate of 35.1% (13/37) from the perspective of the patients and 42.2% (27/64) from the perspective of the tumors. The 1-year recurrence-free rate was 72.2% in the WLC group and 85.2% in the NBI group (p=0.3).
NBI had benefits for detecting tumors overlooked by WLC. Although the difference in the 1-year recurrence-free rate was not statistically significant, our results showed a trend for higher recurrence in the NBI group.
本研究旨在评估窄带成像(NBI)在膀胱镜检查中作为诊断工具与白光膀胱镜(WLC)相比检测膀胱肿瘤的效果。
2013 年 12 月至 2017 年 6 月,由一名外科医生对 198 例行经尿道膀胱肿瘤切除术的患者进行了一项随机前瞻性研究。根据诊断方法将患者分为两组。在第 I 组中,仅行 WLC。在第 II 组中,WLC 后行 NBI。我们将膀胱肿瘤的检出率作为主要终点进行分析。此外,我们评估了每组的复发率。
两组患者的特征除高血压外无显著差异。在检出率分析中,WLC 组癌症诊断率为 80.9%(114/141),NBI 组 WLC 诊断癌症的概率为 85.5%(159/186)。在 NBI 组中,将 WLC 切换为 NBI 进行二次膀胱镜检查后,从患者的角度来看,NBI 显示出额外肿瘤的检出率为 35.1%(13/37),从肿瘤的角度来看,检出率为 42.2%(27/64)。WLC 组 1 年无复发生存率为 72.2%,NBI 组为 85.2%(p=0.3)。
NBI 有利于发现 WLC 漏诊的肿瘤。尽管 1 年无复发生存率的差异无统计学意义,但我们的结果显示 NBI 组的复发率有升高趋势。