非肌层浸润性膀胱癌电切术后尿液脱落细胞检查的临床应用  

Clinical application of urine cytology after transurethral resection of bladder tumor for non-muscle invasive bladder cancer

作　　者：廖有刚 王志[1] 龙建华 雷波[1] 李维[1] 张家铭[1] 申凯[1] Liao Yougang;Wang Zhi;Long Jianhua;Lei Bo;Li Wei;Zhang Jiaming;Shen Kai(Department of Urology,Jiangyou People's Hospital,Sichuan Mianyang 621700,China;Department of Neurology,Jiangyou People's Hospital,Sichuan Mianyang 621700,China)

机构地区：[1]江油市人民医院泌尿外科,四川绵阳621700 [2]江油市人民医院神经内科,四川绵阳621700

出　　处：《现代肿瘤医学》2019年第12期2140-2142,共3页Journal of Modern Oncology

基　　金：绵阳市卫生计生委科研课题(编号:2016-80)

摘　　要：目的:探讨非肌层浸润性膀胱癌电切术后尿液脱落细胞检查与肿瘤残留、复发的相关性,探索术后尿液脱落细胞学阳性作为二次电切手术指针的可行性。方法:将2016年3月至2018年3月在本院诊断为非肌层浸润性膀胱癌96例患者纳入本研究,分别对电切术前、术后[分别于手术室、术后第一天、术后四周(每周一次)]收集新鲜尿液行尿液脱落细胞检查,术后常规膀胱灌注吉西他滨(术后即刻灌注,前四周,每周一次;后每月一次,共1年),术后随访至肿瘤复发或满两年。统计各个研究时间段非肌层浸润性膀胱癌尿液脱落细胞学阳性率情况。结果:96例非肌层浸润性膀胱癌患者术前尿液脱落细胞检查阳性15例,术后即刻尿液脱落细胞检查阳性86例,术后第一天尿液脱落细胞检查阳性32例,术后第一周尿液脱落细胞检查阳性10例,术后第二周尿液脱落细胞检查阳性5例(均行二次电切,证实为肿瘤残留),术后三周、四周尿液脱落细胞检查阴性。在两年的随访期内共15例证实为肿瘤复发,其中4例为尿液脱落细胞检查阳性。结论:非肌层浸润膀胱癌行电切术后通过连续多次进行尿液脱落细胞检查发现尿液中播散的癌细胞以及创面残余癌组织存在,可作为决定是否进一步行二次电切手术的备选条件。Objective:To investigate the efficacy of urine cytology after transurethral resection of bladder tumor(TURBT) for non-muscle invasive bladder cancer(NMIBC) and the significance of repeat transurethral resection with urine cytology.Methods:A total of 96 patients with non-muscle invasive bladder cancer in our hospital from March 2016 to March 2018 who were treated by transurethral resection were included in this study.The pre-operative and post-operative [immediate,the first day after TURBT,four week after TURBT(weekly)] fresh urine was collected.Adjuvant intravesical chemotherapy(gemcitabine) instillation were made for all case.All the patients were followed-up until tumor recurrence or 2 years.Urine cytology was observed.Results:The cytology positive cases in this study was 15(preoperative),86(immediately after TURBT),32(the first day after TURBT),10(the first week after TURBT),5(the second week after TURBT,tumor residual indicated by the second resection).The cytology negative was performed in the third and fourth week after TURBT.A total of 15 cases were confirmed as tumor recurrence during the two-year follow-up period,which 4 cases were positive for urine cytology.Conclusion:After transurethral resection of bladder tumors,the circulating tumour cells and residual tumor cells at the resection site can been found by repeated urine cytology,which could be used as an alternative condition for second resection.

关 键 词：非肌层浸润性膀胱癌 经尿道膀胱肿瘤电切术 脱落细胞学检查 复发 二次电切 

分 类 号：R737.14[医药卫生—肿瘤]