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在柔性囊镜检查期间,用探针式共聚焦激光内显微镜对泌尿腺癌进行分级

Ben-Max de Ruiter^1,2,3, Jan Erik Freund^4,5,6, C Dilara Savci-Heijnink^4,6

¹Department of Urology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands. b.deruiter@amsterdamumc.nl.

World journal of urology

|July 27, 2024

概括

同焦激光内显微镜 (CLE) 显示出在囊镜检查期间分级泌尿道膀癌 (UCB) 的潜力. 然而,目前的诊断准确性和观察者间的协议不足以用于临床使用.

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:

尿路膀癌 (UCB) 管理需要频繁的囊镜和手术.
同焦激光内分显微镜 (CLE) 提供实时显微镜评估,可能使门诊UCB分级成为可能.

研究的目的:

评估灵活CLE (fCLE) 的诊断准确性,用于UCB的分级.
通过使用fCLE评估UCB分级的观察者间变异性.

主要方法:

潜在的纳入患者通过尿道切除皮质膀瘤的患者.
由两个独立观察员进行的手术内fCLE评估,将瘤分类为低级UC (LGUC),高级UC (HGUC) 或良性.
组织病理学作为参考标准;使用科恩的卡帕 (κ) 计算的观察者间一致性.

主要成果:

组织病理学证实了34个病变中的14个HGUC,14个LGUC和6个良性瘤.
fCLE实现了80-85%的诊断收益率,整体分类的 κ=0.75.
诊断性能指标 (灵敏度,特异性,PPV,NPV) 在不同瘤等级之间存在显著差异,LGUC和HGUC分级的显著局限性.

结论:

灵活的CLE (fCLE) 显示了适度的观察者间一致性 (κ=0.61),但目前不足以准确的UCB分级.
为了在膀癌管理中的临床应用,需要进一步完善fCLE技术和解释.

关键词:

膀癌是一种癌症.同焦点激光内分显微镜.囊镜检查囊镜检查囊镜检查诊断诊断诊断诊断

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