Cancer - Bladder, Pelvis, Ureter & Others(구연) Oral Session 4 / Cancer - Bladder, Pelvis, Ureter & Others (Ⅰ) (O-032) Geumkang Hall (Avenue 2F) 11월28일(수) 13:00-14:00 경요도적 방광종양 절제술 시 탐침 기반 공초점 레이저 내시경을 이용한 방광 종양 진단의 정확성 및 치료의 효율성 연세대학교 의과대학 신촌 세브란스 병원 비뇨의학교실¹ 경상대학교 의과대학 비뇨의학교실² 이종수¹, 제성욱², 고동훈¹, 정두용¹, 김민석¹, 고혁준¹, 이주용¹, 최영득¹ Objectives: To assess the diagnostic accuracy and therapeutic efficacy of probe-based confocal laser endomicroscopy (pCLE) which provides real-time, in vivo histological information while performing transurethral resection of bladder tumor. Materials and Methods: We performed a prospective study between August 2013 and August 2014 and pCLE was performed on total of 119 lesions in 75 patients. We analyzed diagnostic accuracy of pCLE with the report of confocal images and pathologic reports of surgical specimen. Confocal images were interpreted by a single urologist while blinded to pathologic reports. The therapeutic was analyzed by comparing pCLE group and non-pCLE group. Results: In total of 119 lesions, 23 were benign, and 96 were malignant. The detection accuracy with pCLE, sensitivity and PPV for malignant lesions were 91.7 % and 93.6 %, respectively. For high-grade versus low-grade bladder cancer, sensitivity and PPV of pCLE were 94.5 % and 89.7 %, respectively. Defining CIS from inflammatory lesions were also accurate with sensitivity, specificity and PPV of 71.4 %, 81.3 %, 83.3 %, respectively. Comparing pCLE group with non-pCLE group, Kaplan-Meier curve revealed recurrence-free survival rate was significantly higher in the pCLE group (p = 0.031). Conclusions: pCLE can be a promising method to detect malignant lesions of the bladder regardless of tumor appearance. It has a high accuracy of differentiating CIS, low- and high-grade urothelial carcinomas with additional therapeutic efficacy by informing the surgeon by real-time tumor histology which may tow to more appropriate procedure and longer recurrence free period. This may also have potential to effect the conventional manner of TUR-BT and reduce recurrence rate. keywords : Urinary Bladder Neoplasms; Diagnosis, Therapeutics; Microscopy, Confocal