1163 NARROW-BAND IMAGING FLEXIBLE CYSTOSCOPY IN THE DETECTION OF NEW NON-MUSCLE INVASIVE BLADDER CANCER: A RANDOMIZED STUDY

Abstract

You have accessJournal of UrologyBladder Cancer: Detection and Screening1 Apr 20101163 NARROW-BAND IMAGING FLEXIBLE CYSTOSCOPY IN THE DETECTION OF NEW NON-MUSCLE INVASIVE BLADDER CANCER: A RANDOMIZED STUDY Yijun Shen, Yiping Zhu, Dingwei Ye, Xudong Yao, Shilin Zhang, Bo Dai, Hailiang Zhang, Yao Zhu, Guohai Shi, Chunguang Ma, and Wenjun Xiao Yijun ShenYijun Shen More articles by this author , Yiping ZhuYiping Zhu More articles by this author , Dingwei YeDingwei Ye More articles by this author , Xudong YaoXudong Yao More articles by this author , Shilin ZhangShilin Zhang More articles by this author , Bo DaiBo Dai More articles by this author , Hailiang ZhangHailiang Zhang More articles by this author , Yao ZhuYao Zhu More articles by this author , Guohai ShiGuohai Shi More articles by this author , Chunguang MaChunguang Ma More articles by this author , and Wenjun XiaoWenjun Xiao More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.663AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Narrow-band imaging(NBI) is an optical image enhancement technique to enhance the contrast between mucosal surfaces and microvascular structures without dyes. Although it is now frequently used in gastrointestinal endoscopy, there are still some controversies about its benefit in the detection of urinary bladder cancer. One of the limitations of previous study is the possible observer bias as white-light imaging (WLI) and NBI were performed subsequently by the same urologist. This study was designed to investigate the detection rate of new non-muscle invasive bladder cancer(NIMBC) between NBI and WLI flexible cystoscopy with a randomized image sequential paradigm. METHODS Between February 2009 and October 2009, NBI and WLI flexible cystoscopy with the same instrument (Olympus Lucera sequential endoscopy system)were both performed on 45 patients with suspected new NIMBC in a randomized image sequential paradigm with the same observing time to avoid the observer bias. Biopsies obtained by NBI and WLI were examined separately for pathology. After biopsy, a standard TUR with resected samples was performed to show presence of tumors or not. RESULTS 41 patients (91.1%) were pathologically NIMBC. Of these 22 were Ta, 14 were T1, 5 were Tis. 89 Of 110 biopsied lesions were found tumor under WLI while 113 of 142 were under NBI. The sensitivity of WLI vs NBI for detecting bladder tumors in all 45 patients was 80.5% vs 97.6% (P<0.05), the specificity 50% vs 75% (P<0.05), the accuracy 77.8% vs 95.6% (P<0.05), and the AUC was 0.652 vs 0.863(P>0.05). All 5 Tis were detected by NBI while 2 missed by WLI. NBI detected 24 additional cancer lesions in 15 of 41 patients, as compared with WLI (P<0.05). CONCLUSIONS NBI flexible cystoscopy improved the detection of NIMBC over standard WLI cystoscopy, contributing to its high value in the clinical practice of bladder cancer. Shanghai, People's Republic of China© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e450-e451 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Yijun Shen More articles by this author Yiping Zhu More articles by this author Dingwei Ye More articles by this author Xudong Yao More articles by this author Shilin Zhang More articles by this author Bo Dai More articles by this author Hailiang Zhang More articles by this author Yao Zhu More articles by this author Guohai Shi More articles by this author Chunguang Ma More articles by this author Wenjun Xiao More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...