吡柔比星对膀胱内扁平恶性病变定位诊断和治疗价值探讨
Role of pirarubicin in the localization diagnosis and treatment of flat malignant bladder cancer
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摘要:目的 探讨吡柔比星(THP)对膀胱内扁平恶性病变的诊断和治疗价值。方法 对需要经尿道膀胱肿瘤电切术的37例患者术前行膀胱镜检查, 观察并记录膀胱内肿瘤生长情况, 灌注吡柔比星(50 mg+5%葡萄糖水50 mL)并保留15 min, 第二次膀胱镜检, 观察膀胱壁内扁平黄染区域并取活检, 未染色区域随机取材活检, 最后行膀胱肿瘤电切术, 术后随访6个月。结果 36例肿瘤患者中, 19例患者发现扁平THP染色区域, 总染色率为66.7%(24/36), 膀胱肿瘤组织染色率58.3%(21/36)。THP染色灵敏度为86.2%(25/29), 特异度为94.8%(148/156)。6个月复发率为25.0%(4/16)。结论 用THP作为染色剂, 对膀胱内扁平恶性病变诊断有一定价值, 操作简便、安全, 此方法指导的膀胱肿瘤电切术能够降低患者复发率。Abstract:Objective This work aimed to evaluate the diagnostic value and therapeutic effect of pirarubicin(THP) on flat malignant lesions in the bladder.Methods Cystoscopic examination of patients required to undergo trans-urethral resection of bladder tumor(TUR-BT) was conducted, and tumor growth in the bladder was observed.Pirarubicin perfusion(50 mL of 50 mg + 5% GS) was performed in the bladder and maintained for 15 mins.Afterwards, cystoscopic examination of the patients was conducted again, and flat malignant lesions with a yellow region in the urinary bladder wall was observed.Biopsy was then performed in this region and in a random non-stained area.TUR-BT therapy was performed in all patients, with a 6-month follow-up period after the operation.Results Flat malignant lesions in THP-stained areas were found in 19 of the 36 tumor patients.The total staining rate was 66.7%(24/36), and the staining rate of bladder tumor tissue was 58.3%(21/36).The sensitivity and specificity of the TPH staining method were 86.2%(25/ 29) and 94.8%(148/156), respectively.Conclusion As a staining method, THP is safe and easy to operate and can diagnose flat malignant lesions in the bladder.The method can also reduce the recurrence rate of TUR-BT to a certain extent with the aid of THP.
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