用蓝光囊泡镜监测非肌肉侵入性膀癌:一个元分析
Reza Sari Motlagh1, Alireza Ghoreifi2, Takafumi Yanagisawa1,3
1Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
BJU international
|April 24, 2024
概括
灵活的蓝光囊镜 (BLC) 检测出比白光囊镜 (WLC) 更多的非肌肉侵入性膀癌 (NMIBC) 复发,但可能会增加错误阳性. 在NMIBC患者的BLC监测中建议采用风险分层方法.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 在瘤学瘤学.
- 医疗成像医学成像
背景情况:
- 非肌肉侵入性膀癌 (NMIBC) 需要警监测以检测复发.
- 灵活的囊镜是NMIBC监测中的一个关键工具.
- 蓝光囊镜 (BLC) 与标准白光囊镜 (WLC) 相比,提供了增强的可视化.
研究的目的:
- 为了比较柔性蓝光囊镜 (BLC) 与柔性白光囊镜 (WLC) 的诊断准确性,用于检测NMIBC患者的复发.
- 评估BLC在监测期间识别可疑膀病变方面的有效性.
主要方法:
- 进行了系统审查和元分析,搜索主要数据库,查找2023年5月之前发表的符合条件的研究.
- 包括的研究遵循了PRISMA指南.
- 主要结局是灵活BLC和WLC在检测膀癌复发中的比较准确性.
主要成果:
- 对10项研究 (1,634名患者) 的分析发现,灵活BLC和WLC (OR 1.08) 之间的整体复发检测没有显著差异.
- 灵活的BLC显示了检测所有复发 (72%对66%) 和 carcinoma in situ (CIS) (39%对29%) 的更高的积极预测值.
- 对于CIS检测的子组分析也显示没有显著差异 (OR 1.19),尽管BLC的假阳性率更高.
结论:
- 灵活的BLC可以在NMIBC监测中识别比WLC更多可疑的病变和复发.
- 随着检测的增加,错误阳性率更高,可能导致过度治疗.
- 风险分层的患者选择策略可以优化在NMIBC监测中使用灵活的BLC.
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