| Objective: To systematically evaluate evidence on the clinical diagnostic accuracy and early recurrence risk of photodynamic diagnosis(PDD)and narrow band imaging(NBI)versus white light imaging(WLC)in patients with bladder cancer.Methods: The databases have been searched included Cochrance Libarary,PubMed,Web of Science,Embase,WanFang,VIP,CNKI and CBM before January,2018.Outcomes interest include patient level of overall detection rates and 1 year bladder cancer recurrence rate.Results: 35 articles have been studied and they contained 7205 patients in total.In per-patient analysis,the result shows that the pooled sensitivity of PDD was significantly higher than white light imaging(RR0.855,95% CI 0.787,0.996;p = 0.042)for overall bladder cancer detection.However,there was no significant difference in the detection rate of carcinoma in situ(CIS)(RR0.508,95% CI 0.195,1.322;p = 0.165).And the pooled sensitivity of NBI was significantly higher than white light imaging for overall bladder cancer detection(RR0.928,95% CI 0.863,0.998;p = 0.044)and additional bladder tumor detection(RR0.224,95%CI 0.162,0.308;p = 0.000).However,there was no significant difference in the detection rate of CIS(RR0.812,95% CI 0.614,1.075;p = 0.145).All of the data shows that biochemical failure in1 year was fewer in patients who received photodynamic diagnosis-assisted transurethral resection of bladder tumour(TURB)(RR1.435,95% CI 1.211,1.702;p = 0.021)and narrow band imagingassisted transurethral resection of bladder tumour(TURB)(RR1.451,95% CI 1.079,1.951;p =0.014).Conclusion: Photodynamic diagnosis and narrow band imaging significantly improved the detection rate of bladder cancer and reduced the recurrence rate of non-muscle-invasive bladder cancer(NMIBC)compare with white light imaging in 1 year. |
