在急性囊切除过程中,尿道冷截面分析是否仍有作用?
Attilio Barretta1, Pietro Piazza1,2, Calogero Catanzaro1
1Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
BJU international
|December 26, 2025
概括
膀癌 (BCa) 激进囊切除术 (RC) 期间远端尿道边缘的手术内冷截面分析 (iFSA) 是非常准确的. 由iFSA确定的积极边际与较差的瘤结果相关,支持其用于指导手术决策.
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.
- 手术病理学手术病理学
背景情况:
- 激进囊切除术 (RC) 是肌肉侵入性膀癌 (BCa) 的标准治疗方法.
- 在RC期间评估远端尿路边缘对于预防上泌尿道复发 (UUTR) 至关重要.
- 业内冷部分分析 (iFSA) 提供实时保证金评估.
研究的目的:
- 评估常规iFSA的诊断准确性和瘤实用性,用于BCa患者接受RC的远端尿路边缘.
- 为了确定与积极的远端尿路边缘相关的因素.
- 评估积极边际对生存结果的影响.
主要方法:
- 在2010年至2024年期间,对1081名BCa患者进行RC的回顾性分析.
- 进行远端尿道的双边iFSA,并为正边缘进行额外的切除.
- 使用了诊断一致性,卡普兰-梅尔生存分析 (无UUTR生存,OS,CSS) 和多变量逻辑回归 (MLR).
主要成果:
- 12.9%的患者在iFSA上具有积极的远端尿路边缘,敏感度为98.6%,特异性为99.5%.
- 积极边缘的独立预测因素包括水,T3-T4阶段,膀CIS和三角瘤位置.
- 阳性边际与明显增加的UUTR,更差的整体存活率 (OS) 和更差的癌症特异性存活率 (CSS) 相关.
结论:
- 在RC期间远端尿路边缘的IFSA显示出出色的诊断性能,并促进实现无癌症的解剖.
- iFSA对于指导手术内决策非常有价值,特别是在膀CIS,三角瘤或水缩的患者中.
- 这些发现支持iFSA的常规使用,以优化BCa患者的手术结果和量身定制的术后监测.
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