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

  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。 

Role of pirarubicin in the localization diagnosis and treatment of flat malignant bladder cancer

  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.