3D NLS plays an important role in bladder tumors

3D NLS plays an important role in bladder tumors
Malignant urinary bladder tumors fill 8th position in male and 18th position in female patients within the structure of oncological diseases. Urinary bladder tumor is in the 4th position among oncourological diseases according to the absolute rate of growth (the first three positions are: prostate cancer, renal cancer and testicular cancer). The multiplicity of rudiments and frequent recuring is characteristic for the tumors of urinary bladder.

 

In all the countries in majority of cases (90-95%) the tumors of urinary bladder are morphologically transient cell carcinomas; the rest of cases relate to squamous cell cancer and adenocarcinoma. Non-epithelial tumors consist less than 1%.

 

Computer tomography, magnetic resonance tomography and transurethral ultrasonic examination are mainly used over the last years as corrective diagnostics methods to determine the depth of urinary bladder tumor invasion. According to the information provided by Nesterova V. and others the recent method of 3D NLS-research may become crucial both when specifying the prevalence rate of bladder cancer and when performing case monitoring. Such advantages of the method as availability, painlessness and absence of radiation exposure allow performing multiple researches when carrying out case monitoring.

 

Tumor may be singular but tumors of urinary bladder most frequently have multifocal growth type up to total affection of the whole bladder. Detailed examination of all bladder walls is necessary because of this. Sizes, shape, chromogenecy and intensity of nodules invasion into the wall may be different in case of multifocal growth.

Major problems when performing NLS-research are faced when diagnosing the invasion into the submucous layer or when diagnosing the onset of invasion into the muscular layer. Spectral-entropy analysis often allows solving of such problems.

Tumors (especially endophytic ones) which affect major part of bladder wall may cause its sharp size reduction (microcystis). Small bladder capacity in such patients and also in patients who were surgically treated (often repeated due to repeated relapses) may complicate the detection of tumor’s invasion depth.

 

The ingrowth into prostate gland is typical for tumors of urinary bladder located in the area of urinary triangle; and ingrowth into urinary bladder wall is typical for prostate gland tumors. Differential diagnostics of organ affiliation of prostate gland and urinary bladder tumors in case of ultramicroscanning has no real difficulties in 95% of patients. Although there may appear some diagnostic difficulties if the process is locally advanced and when urinary bladder in the area of urinary triangle and prostate gland (in rare cases when multifocal tumoral affection of both organs is present) are involved into this process.

In majority of cases the clinical picture in such patients does not allow performing differential diagnostics. Regardless of primary tumor localization there is distinct ankylurethria, often chronic urine retention (especially if the tumor developed in patient with benign prostatic hyperplasia), pain syndrome and macrohaematuria. Clinical picture does not exclude the possibility of prostate cancer and normal level of prostate-specific antigen. The increase of prostate-specific antigen is not an absolute diagnostic indicator of prostate cancer; although prostate-specific antigen is an organo-specific glycoproteid it is not OncoMarker itself.

 

The most statistically reliable method of NLS-research in case of urinary bladder tumors is an ultramicroscopic research with the usу of spectral-entropy analysis. Such method provides the detection of the tumor less than 3 mm., specifies its localization and in case of its invasive form it allows specifying its proportion in relation to adjacent organs and tissues. It is possible to examine the layers of bladder wall in all patients when using 3D NLS-ultramicroscopic research. We use spectral-entropy analysis in case of any process localization in urinary bladder after performance of ultramicroscopic research. Only endocavitary ultramicroscopic research is the most effective method for examination of all tumor aniages in case of multicentric growth.

 

The visualization of small sized formations (less than 4 mm.) is complicated in case of common non-scaling NLS-research; in more rarely cases the visualization of larger tumors located on the frontal urinary bladder wall is complicated. Performance of spectral-entropy analysis with ultramicroscanning always helps to make correct diagnosis in cases like these. The frontal urinary bladder wall which is put close to an abdominal wall is visualized with considerable zooming in, which allows examining both wall layers and their correlation with tumor nodule..

 

At the present time we are able to use extensively NLS-research of urinary bladder tumors with 3D reconstruction. The method allows visually presentation of the tumor and its correlation with surrounding tissues when making decision on choosing of surgical procedures type, and it allows storing the information in digital format.

 

Information storing provides the possibility for attending doctors to subsequently review the whole 3D information block which gives more objectiveness to 3D NLS-research.