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目的:探讨经尿道膀胱肿瘤电切术(TURBT)中基底病理活检临床价值。方法:选取2012年7月至2016年7月广东省饶平县人民医院行TURBT术治疗的80例膀胱癌患者,按术后有无行基底病理活检分为两组:观察组与对照组,观察组进行电切基底部标本病理活检,比较两组肿瘤复发、进展情况。结果:观察组发现肌层浸润性膀胱癌4例,行二期全切膀胱根治术;非肌层浸润性尿路上皮癌36例,其中行二次TURBT术11例(活检无肌层组织6例、活检为上皮异形增生5例),活检无异常25例;对照组发现肌层浸润性膀胱癌7例,其中姑息治疗4例,行膀胱保留术3例;另外33例均为非肌层浸润性膀胱癌(NMIBT),其中复发后行淋巴结清扫+膀胱全切术8例;术后随访1年,观察组肿瘤复发率27.50%,进展率30.00%均比对照组低,差异具有统计学意义(P<0.05)。结论:经尿道膀胱肿瘤电切术中基底病理活检可确定肿瘤分级、分期,检出残余肿瘤,确定电切深度、范围,为二次电切术提供参考信息。
Objective: To investigate the clinical value of basal biopsy in transurethral resection of bladder tumor (TURBT). Methods: From July 2012 to July 2016, 80 cases of bladder cancer treated with TURBT in People’s Hospital of Raoping County, Guangdong Province were divided into two groups according to the presence or absence of biopsy: observation group and control group, In the observation group, the biopsy specimens of the basal part of the resected tissue were taken and the recurrence and progression of the tumors in both groups were compared. Results: In the observation group, 4 cases of myasthenic invasive bladder cancer were found, and the second stage total cystectomy was performed. 36 cases of non-myometrial invasive urothelial carcinoma were treated with secondary TURBT (biopsy without myometrial tissue 6 Cases, biopsy for epithelial dysplasia in 5 cases), biopsy no abnormalities in 25 cases; control group found in 7 cases of muscle invasive bladder cancer, palliative treatment in 4 cases, 3 cases of bladder retention; the other 33 cases were non-muscular (NMIBT). Among them, 8 cases were treated with lymph node dissection and total cystotomy after the recurrence. The follow-up of 1 year after operation showed that the recurrence rate was 27.50% in the observation group and the progression rate was 30.00%, which was lower than that in the control group Significance (P <0.05). Conclusion: Tumor biopsy in transurethral resection of bladder tumor can confirm tumor grade and staging, detect residual tumor, determine the depth and range of resection, and provide reference information for resection.