Qiu M, Xu C X, Wang B S, Yan Y, Deng S H, Xiao C L, Liu C, Lu J, Tian X J, Ma L L
Beijing Da Xue Xue Bao Yi Xue Ban. 2020 Aug 18;52(4):697-700. doi: 10.19723/j.issn.1671-167X.2020.04.019.
To investigate the effect of NBI assisted white light transurethral resection of bladder tumor (TURBT) in the treatment of bladder urothelial carcinoma and to summarize the experience of narrow band imaging (NBI) operation.
Patients with bladder urothelial carcinoma were selected, and TURBT was performed after anesthesia. First of all, the bladder tumor was found and resected under white light. Then we replaced with NBI, looked for suspicious lesions and resected them, The specimens excised under white light and NBI were collected separately. The number, location and pathological results of the lesions under white light were recorded, and the residual lesions under NBI were also recorded. To evaluate the effect of NBI, the ratio of residual bladder tumor was calculated. The cases were divided into three groups according to the time sequence. The clinical data of each group were collected and the learning curve of TURBT under NBI assisted white light was observed.
A prospective study of 45 patients with bladder tumor from April 2018 to January 2020, including 32 males and 13 females, aged from 23 to 89 years, with an average age of 65.2 years. All the operations were successfully completed, without obvious complications after operation. Nine cases were single and 36 cases were multiple. The maximum diameter of the tumors was 0.5 to 4.0 cm, with an average of 2.2 cm. The histopathology of the resected tissue under white light was urothelial carcinoma, and 19 cases (42.2%) were pathologically positive by NBI resection. The 45 cases were divided into three groups according to the time sequence, 15 cases in each group. The true positive rate of NBI was 33.3%, 46.7% and 46.7%, respectively, and the false positive rate was 60.0%, 46.7% and 26.7%, respectively in the three groups.
TURBT is an effective way to treat bladder urothelial cancer, NBI is an effective supplement of white light, which can increase the detection rate of bladder cancer and reduce post-operative recurrence. The NBI light source has a certain learning curve. With the increase of cases, the false-positive rate of NBI is gradually reduced. After the NBI operator has rich experience, the recognition degree of flat tumor is gradually improved under white light, and the residual rate of NBI is reduced after the removal under white light.
探讨窄带成像（NBI）辅助白光经尿道膀胱肿瘤电切术（TURBT）治疗膀胱尿路上皮癌的效果，并总结窄带成像操作经验。
选取膀胱尿路上皮癌患者，麻醉后行TURBT。首先在白光下找到并切除膀胱肿瘤，然后更换为NBI，寻找可疑病变并切除，分别收集白光及NBI下切除的标本。记录白光下病变的数量、位置及病理结果，同时记录NBI下的残留病变。计算残留膀胱肿瘤比例以评估NBI的效果。按时间顺序将病例分为三组，收集每组临床资料，观察NBI辅助白光下TURBT的学习曲线。
对2018年4月至2020年1月45例膀胱肿瘤患者进行前瞻性研究，其中男性32例，女性13例，年龄23～89岁，平均年龄65.2岁。所有手术均顺利完成，术后无明显并发症。单发9例，多发36例。肿瘤最大直径0.5～4.0cm，平均2.2cm。白光下切除组织病理为尿路上皮癌，NBI切除病理阳性19例（42.2%）。45例按时间顺序分为三组，每组15例。三组NBI真阳性率分别为33.3%、46.7%、46.7%，假阳性率分别为60.0%、46.7%、26.7%。
TURBT是治疗膀胱尿路上皮癌的有效方法，NBI是白光的有效补充，可提高膀胱癌检出率并降低术后复发率。NBI光源有一定学习曲线，随着病例数增加，NBI假阳性率逐渐降低。NBI操作者经验丰富后，白光下对扁平肿瘤的识别度逐渐提高，白光切除后NBI残留率降低。
