En bloc resection improves the identification of muscularis mucosae in non-muscle invasive bladder cancer
En bloc resection improves the identification of muscularis mucosae in non-muscle invasive bladder cancer
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整块切除提高了非肌层浸润性膀胱癌粘膜肌层的识别
DOI：
10.1007/s00345-019-02672-3
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发表时间：
2019-12-01
影响因子：
3.4
通讯作者：
Fan, Jinhai
中科院分区：
文献类型：
--
作者：
Liang, Hua;Yang, Tao;Fan, Jinhai
目的根据粘膜肌层（MM）与肿瘤的关系，T1分期是T1期膀胱癌有希望的预后因素。然而，MM在标本中的识别率较低，因此在临床实践中没有广泛使用。在这项研究中，我们探讨了是否整块切除的非肌肉浸润性膀胱癌（NMIBC）可以提高识别粘膜肌层（MM），这可能进一步准确识别的T1 substages.Patients和方法标本从158例原发NMIBC回顾性分析了两个独立的病理学家，以评估MM的存在和分层的T1 substage。在158个标本中，70个标本是通过TURBt与等离子体动力学回路获得的，88个是通过前射磷酸钛氧钾（KTP）绿光激光整块切除获得的。采用单因素和多因素Logistic回归模型分析MM的临床特征与MM的关系。结果MM的平均年龄为58.22岁（18-85岁）。多变量logistic回归分析显示，KTP激光切除方法与标本中MM的存在相关（P = 0.008）。此外，也可以用TURBt整块切除的较小尺寸的肿瘤（例如，
Purpose The T1 substage, according to the relationship between muscularis mucosae (MM) and tumors, is a promising prognostic factor for T1 bladder cancer. However, the identification rate of MM is low in specimens, and it is, therefore, not widely used in clinical practice. In this study, we investigated whether en bloc resection of non-muscle invasive bladder cancer (NMIBC) could improve the identification of muscularis mucosae (MM), which may further accurate identification of the T1 substage.Patients and methods Specimens from 158 patients with primary NMIBC were retrospectively reviewed by two independent pathologists to assess the presence of MM and stratify the T1 substage. Of 158 specimens, 70 specimens were obtained via TURBt with a plasma kinetic loop and 88 were obtained via front-firing potassium-titanyl-phosphate (KTP) green-light laser en bloc resection. Univariable and multivariable logistic regression models were used to analyze the relationship between the clinical characteristics and the presence of MM.Results The mean age was 58.22 years (range 18-85 years). Multivariable logistic regression analysis showed that the KTP laser resection method was associated with the presence of MM in specimens (P = 0.008). In addition, tumors with smaller sizes, which could also be en bloc resected with TURBt (e.g.,