İdrar sitolojisi ve üriner sistem ultrasonografisinin mesane tümörlü hastaların takibindeki yeri

Year 2014, Volume: 9 Issue: 1, 8 - 13, 01.01.2014

İbrahim Karabulut Turgut Yapanoğlu Fatih Özkaya Şenol Adanur Tevfik Ziypak

Abstract

Amaç: Mesane tümörleri ilk tespit edildiklerinde %70 oranında yüzeyel tümörlerdir. Bu yüzeyel tümörler nüks etme eğilimindedirler. Hastalarda oluşabilecek nüksleri tespit edebilmek için belirli periyotlarda invazif işlem olan sistoskopi ile takip etmek gerekmektedir. Biz bu invazif işlem yerine üriner USG ve sitolojinin birlikte kullanılabilirliğini araştırmayı amaçladık. Gereç ve Yöntemler: Çalışmaya dahil edilen hastalar konu hakkında bilgilendirildikten sonra, onam formları alındı. İdrar yolu enfeksiyonu olanlar, kalıcı üretral kateter taşıyan hastalar, kemoterapi , immunoterapi ve radyasyon tedavisi alanlar, aktif prostat kanserliler, son iki ay içerisinde mesane veya üriner sisteme yönelik endoskopik girişim ya da cerrahi geçiren olgular çalışma dışı bırakıldılar.Hastalardan sistoskopi öncesi klinik şartlarında miksiyonla elde edilen idrar ve ameliyathane şartlarında sistoskopi öncesi mesane yıkama suyu sitolojik tetkik için gönderildi. Yine sistoskopi öncesi hastaların klinik şartlarında USG ile mesaneleri değerlendirildi. Üriner sistem USG’nin aynı hekim tarafından tüm hastalarda aynı optimum şartlar oluşturularak yapılması sağlandı.Tarama testlerinin performanslarını değerlendirmede istatistiksel analiz yöntemi olarak ROC analiz yöntemi kullanıldı. pİ0,05 olması durumunda fark istatistiksel olarak anlamlı kabul edildi.Bulgular: Mesane tümörü tanısı konulan 296 hastanın yaş ortalaması 65,9±14,8 idi. Hastaların tedavi edici transüretral rezeksiyondan sonra geçen izlem süreleri 3-39 ay idi. 20% . In the urinary USG, 98 of the patients 33% had lesions. As a result of the use of both parameters, the results in 83 patients 28% were evaluated as positive. As a result of a binary comparison of diagnostic tests, between urinary cytology and USG was found to be a significant difference. In addition, there was a significant difference between using cytology and urinary system ultrasound combined use. But, we identified that there was no a significant difference between using urinary system ultrasound and cytology and urinary system ultrasound combined use.Conclusions: In the patients whom cystoscopy wasn’t made for any reasons, we think that USG and cytology could be used the reason for high reliability and low error shape

Keywords

Mesane Tümörü , sitoloji , sistoskopi , üriner sistem USG

The role of urine cytology and urinary system ultrasound in follow-up of patients with bladder tumor

Abstract

Objective: When first diagnosed, bladder tumors are superficial one in the proportion of 70%. These superficial tumors have tendency of recurrence. In order to be able to detect the recurrence which will occur in patients, it is necessary to pursue with cystoscopy, an invasive process in certain periods. Instead of this invasive process, we aimed to investigate the use of urinary USG along with cytology.Material and Methods: The approvals were taken after informing patients. The patients who had urinary infections, urethral catheter, chemotherapy, immunotherapy, radiotherapy, active prostate cancer and endoscopic or surgery procedures for urinary system were not included in this study.The cytology samples which obtained by spontaneous miction in the clinical condition and from bladder washing water in the surgery condition before cystoscopy were sent. And also, the bladders were evaluated by Urinary System USG in clinical condition before cystoscopy. It was provided that the Uriner System USG was applied to all the patients by same surgeon by keeping same optimum condition.The ROC statistical method was used to evaluate performance of survey test and if the p value was p < 0.05, the differences were accepted statistically significant.Results: The average age of the 296 patients diagnosed bladder tumor was 65,9±14,8 years. Follow-up time after transurethral resection was 3-39 months.Positive result was obtained in 62% of the patients by means of cytologic examination 20% . In the urinary USG, 98 of the patients 33% had lesions. As a result of the use of both parameters, the results in 83 patients 28% were evaluated as positive. As a result of a binary comparison of diagnostic tests, between urinary cytology and USG was found to be a significant difference. In addition, there was a significant difference between using cytology and urinary system ultrasound combined use. But, we identified that there was no a significant difference between using urinary system ultrasound and cytology and urinary system ultrasound combined use.Conclusions: In the patients whom cystoscopy wasn’t made for any reasons, we think that USG and cytology could be used the reason for high reliability and low error shape

Keywords

Bladder Tumor , cytology , cystoscopy , urinary system ultrasonograpy

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