NBI Cistoscopy increase the detection rate of Carcinoma in situ; RUA’S experience

==inizio abstract==

The aim of this study was to evaluate the capacity of NBI to increase the detection rate of lesions not visible with WL cistoscopy and if we can increase the visibility of Carcinoma in situ (CIS)

From June 2010 to April 2012, 797 patients, underwent to WL plus NBI cystoscopy and subsequently to Bipolar TURBt. In 797 patients, we identified a total of 1571 suspected lesions, of which 496 were single lesions and 1075, instead, multiple lesions. The use of cystoscopy with WL has allowed the identification of 1337 lesions. With the subsequent use of NBI light, we discovered 234 lesions not otherwise visible with WL

In our experience, the use of NBI significantly increases the ability of WL cystoscopy in identifying lesions (p<0.05) Using NBI during cystoscopy we found out 234 suspicious lesions not visisble to WL, 127 (12,1%) of those after TURBt resulted in bladder neoplasms. About this lesions NBI+ WL- 15 was CIS, 12 was a primate lesions and 3 was recurrence. The use of NBI cystoscopy is useful in the identification of CIS lesions. Despite the high rate of false positives (35,75%), the overall capacity of NBI cystoscopy to increase the predictive power to identify suspicious bladder lesions, significantly increases compared to the use of WL cystoscopy alone. In our experience, the use of NBI cystoscopy compared to WL Cystoscopy, was particularly useful in the identification of CIS lesions, showing a sensitivity and a NPV of 100% vs. 80.62% and 100% vs. 78.35%, (p<0.05). We can conclude that the combination of WL and NBI cystoscopy before TURBt is an economic and better diagnostic in the bladder tumours and in particolary in the Carcinoma in situ. ==fine abstract==