盐酸吡柔比星荧光膀胱镜对非肌层浸润性膀胱癌的诊断价值

摘要

Objective:To assess the value of pirarubicin－induced fluorescence cystoscopy in the diagnosis of non-muscle invasive bladder carcinoma.Methods:40 mg pirarubicin was dissolved in 40 ml 5％GS solution and instilled intravesically.Fluorescence cystoscopy and white light cystoscopy were performed for 63 patients.Lesions found either under white light or fluorescence light were biopsied and then resected.Results:92 biopsies were taken from 45 pa-tients.Histopathologic examination showed that 53 sites of them were urothelial carcinoma.Statistic analysis indicated a sensitivity of 90.57％(48/53)and a specificity of 64.10％(25/39)for fluorescence cystoscopy,and a sensitivity of 71.70％(38/53)and a specificity of 56.41％(22/39)for white light cystoscopy.Conclusion:Pirarubicin－in-duced fluorescence cystoscopy has proved to be a valuable detection method with high sensitivity and spectivity for the nonmuscle invasive bladder carcinoma.%目的:评估以盐酸吡柔比星作为荧光剂的荧光膀胱镜检查对非肌层浸润性膀胱癌的诊断价值.方法:本次研究共63例患者,膀胱灌注盐酸吡柔比星溶液40 mg,保留30 min后排空置入膀胱镜,分别在普通白光及荧光下观察,对白光和/或荧光下显示阳性或可疑区域进行活检,同时行电切术.结果:63例患者中,18例患者普通白光膀胱镜及荧光膀胱镜检查均阴性;其余45例患者共取活检92处,平均每例患者取活检2.04处.其中53处病理报告为尿路上皮癌,荧光膀胱镜敏感性为90.57％(48/53),特异性为64.10％(25/39);普通白光膀胱镜敏感性为71.70％(38/53),特异性为56.41％(22/39).结论:吡柔比星荧光膀胱镜诊断非肌层浸润性膀胱癌的敏感性和特异性均显著高于普通白光膀胱镜,具有较高的临床应用价值.