5-ALA荧光膀胱镜的应用对非肌层浸润性膀胱癌早期复发率的影响

Influence of Using 5-aminolevulinic Acid Induced Fluorescence Cystoscopy on Early Recurrence Rate in Non Muscle-invasive Bladder Cancer

目的:探讨5-氨基乙酰丙酸(5-ALA)荧光膀胱镜的应用对非肌层浸润性膀胱癌术后早期复发率的影响。方法:将90例非肌层浸润性膀胱癌患者随机分为两组,每组45例,分别在白光膀胱镜和5-ALA荧光膀胱镜下行TURBt,术后6周所有患者均行5-ALA荧光膀胱镜检查以观察肿瘤复发情况,并对复发肿瘤行二次TURBt。结果:行二次TURBt后,90例患者中,25例(27.7%)发现有肿瘤发生,其中白光膀胱镜组18例(40%),荧光膀胱镜组7例(15.5%),两组间比较差异有统计学意义(P=0.05)。结论:5-ALA荧光膀胱镜对膀胱肿瘤的诊断和治疗具有较高价值,可以显著降低非肌层浸润性膀胱癌术后早期复发率。

Objective：To evaluate the value of using 5-aminolevulinic acid induced fluorescence cystoscopy on early recurrence rate in non muscle-invasive bladder cancer. Methods： In a prospective randomized study 90 patients underwent transurethral resection of bladder tumor（s） either with white light or ALA fluorescence assisted cysto- scopy. A second look transurethral resection with ALA fluorescence cystoscopy was performed 6 weeks after the initial operation. Results： At second look transurethral resection tumor was detected in 18 of 45 patients（40%） in the white light cystoscopy group and in 7 of 45 （15.6%） in the ALA fluorescence cystoscopy group. This differ- ence was statistically significant（P = 0.05）. Conclusions： 5-ALA induced fluorescence cystoscopy is an effective and valuable detection and treatment method which can significantly reduce early recurrence rate in non muscle-invasive bladder cancer.