窄带光谱成像膀胱软镜联合钬激光治疗非肌层膀胱癌的疗效观察*

Therapeutic Eefficacyect of narrow-band spectral imaging of flexible cystoscopy combined with holmium laser on in non-muscle invasive bladder cancer*

摘要:

目的探讨窄带光谱成像膀胱软镜联合钬激光在非肌层浸润性膀胱癌（NMIBC） 患者中的疗效。 方法选取2017年6月—2018年6月于昆明医科大学第二附属医院泌尿外科收治的NMIBC患者60例。根据不同 治疗方法随机分为窄带光谱成像组和白光成像组，各30例。比较两组手术相关指标和并发症情况，比较两组患者 术后1个月、3个月、6个月及12个月的复发率，以及原位、异位肿瘤复发情况。结果窄带光谱成像组术后总复 发率较白光成像组低（P <0.05）。白光成像组肿瘤原位复发率较窄带光谱成像组高（P <0.05）。术后肿瘤复发与 年龄、肿瘤分级、肿瘤分期及膀胱多发肿瘤数目均呈正相关（rs=0.436、0.763、0.537和0.980，P <0.05）。两组围 手术期并发症比较，差异无统计学意义（P >0.05）。两组术后1个月、3个月、6个月及12个月的复发率比较，差 异无统计学意义（P >0.05）。结论窄带光谱成像膀胱软镜联合钬激光治疗NMIBC具有较好的疗效，安全性高， 能够降低NMIBC患者术后复发率，具有临床应用的价值。

Abstract:

Objective To investigate the efficacy of narrow-band imaging (NBI) flexible cystoscopy combined with holmium laser in the treatment of patients with non-muscle invasive bladder cancer (NMIBC). Methods A total of 60 patients with NMIBC admitted into our hospital from June 2017 to June 2018 were enrolled, and were divided into NBI group (30 cases) and white light imaging (WLI) group (30 cases). The surgery-related indicators, perioperative complications, recurrence rates at 1 month, 3 months, 6 months and 12 months after the surgery, and the recurrence rates of in situ and ectopic tumors were compared between the two groups. Results There was no significant difference in the operation time, intraoperative bleeding, duration of indwelling catheter and hospitalization days between the two groups (P >0.05). No significant difference was found in the incidences of perioperative complications between the two groups (P > 0.05). Besides, there was no significant difference in the recurrence rates between the NBI group and the WLI group at different time points (1 month, 3 months, 6 months and 12 months after the surgery) (P > 0.05). The total recurrence rate was 10.0% in the NBI group, which was lower than that in the WLI group (40.0%) (P < 0.05). The recurrence rate of in situ tumors in the WLI group was higher than that in the NBI group (P < 0.05). Postoperative tumor recurrence was positively correlated with age (rs = 0.43, P < 0.05), tumor grade (rs= 0.76, P < 0.05), tumor stage (rs = 0.53, P < 0.05), and the number of tumors in bladder (rs = 0.98, P < 0.05). Conclusions NBI flexible cystoscopy combined with holmium laser exhibits great therapeutic efficacy in NMIBC with high safety, and can reduce the postoperative tumor recurrence, which is of value for clinical application.