The usefulness oitru-cut biopsy to staging carcinoma of the bladder. Experimental study
Article published in Urologia Polska 2003/56/1.
Tomasz Szopiński 1, Piotr Chłosta 2, Tomasz Dzik 3, Grzegorz Kata 1, Artur A. Antoniewicz 1, Andrzej Borówka 1
- 1 Oddzial Urologii Centralnego Szpitala Kolejowego w Warszawie, Zakład Dydaktyki Urologicznej CMKP
Ordynator oddziału: prof, dr hab. Andrzej Borówka
2 Instytut Medycyny EuroMcdiCare Szpital Specjalistyczny z Przychodnią. Oddział Urologii
Ordynator oddziału: dr Piotr Chłosta FEBU
3 Zakład Patomorfologu Centralnego Szpitala Kolejowego w Warszawie
Kierownik zakładu: dr Tomasz Dzik
bladder, bladder carcinoma, tru-cut biopsy, local staging of the tumor
- Introduction. The stage of the neoplasm is one of the most important factors influencing on the choose of method of the treatment of bladder carcinoma. Transurethral resection of the bladder tumor (TURBT) and microscopic examination of the resected specimen are methods of estimation of local staging Of the tumor. Solid nonpapillary tumor or rigid bladder wall seen during cystoscopy may be macroscopic signs of infiltrative bladder carcinoma. Enlarged diagnostic TURBT a big bladder tumor is an invasive procedure with a risk of complications, We examined an ability of transurethral, cystoscopicafly guided Ini-cut biopsy, as a less invasive diagnostic method.
- The aim of this study was an estimation of the usefulness of transurethral cystoscopically guided tru-cut biopsy in the diagnosis of bladder carcinoma infiltrating a detrusor muscle.
- Material and method. We examined 50 urinary bladders removed by cystectomy due to infiltrative carcinoma of the bladder (pT>2). In 15 of them (group I) anterior bladder wall was incised longitudinally and open tru-cut biopsy (3 cores) of macroscopically seen tumor or its relicts after TURBT was done. In other 15 removed bladders (group II) ex vivo cystoscopy was performed using rigid instrument with a tru-cut biopsy (3 cores) of the tissue in the region of previous diagnostic TURBT. All specimens and other bladder tissue underwent pathological examination after hematoxylin - eosin staining. The results of microscopic estimation of tru-cut bioptates and other bladder tissue specimens were compared, with the special regard to local staging and pathological grade of cancer.
- Results. The results of tru-cut bioptate examination revealed muscle infiltration in all cases and was always agree with those of microscopic examination of the bladder in both groups. In group I positive result in only 1 specimen was observed in 4 patients (26.6%), in 2 specimens in 8 patients (5.3,3%), and in all 3 specimens in 3 patients (20%). In group II positive result in only 1 specimen was observed in 4 patients (26,6%), in 2 specimens in 7 patients (46,6%), and in all 3 specimens in 4 patients (26,6%). Tumor grade was the same with those of removed bladder in 12 (80%) specimens of group land in 13 (86,6%) specimens of group n (in 25 specimens. e.g. 83,3%, in both groups). In other patients the grade of tru-cut biopsy specimens were lower than those of the removed bladder tissue.
- These results cannot consider that in patients with possible invasive bladder carcinoma the tru-cut biopsy may replace diagnostic TURBT. However they show, that transurethral tru-cu( biopsy can be useful in solid bladder tumors and its tissue material is representative for microscopic examination. Results of this study may cause introduction of transurethral tru-cut biopsy before TURBT in patients with suspicion of invasive carcinoma of the bladder.
- Conclusion. Endoscopic tru-cul biopsy makes possible to lake a tissue specimen representative for microscopic examination in muscle infiltrating bladder cancer.
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