Carboxycryobiopsy and carboxycryoextraction of bladder tumor. Experimental study

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Abstract

Aim. To evaluate the possibility of performing transurethral carboxycryobiopsy (CCB) and carboxycryoextraction (CCE) of a bladder tumor for pathomorphological examination, as well as to perform a comparative analysis of the safety (quality) of biopsy material (tumor tissue) during standard transurethral biopsy and carboxycryobiopsy.

Materials and methods. In the first experiment in vitro, CCE of bladder tumor fragments obtained after transurethral resection was performed. In the second pilot study, cystoscopy followed by CCB and CCE in a patient with multiple bladder tumors was done. The procedure was performed by transurethral access. During cryopreservation of the bladder tumor, a biopsy was performed. After freezing, the tumor was removed from the bladder and sent for histological examination.

Results. The first experiment showed that cryoextraction of the fragments of a bladder tumor using carbon dioxide (CCE) in vitro is a feasible procedure and allows the evacuation of tumor tissues of various sizes. According to the second experiment, CCB and CCE of the bladder tumor using carbon dioxide allows to obtain a biopsy of a bladder tumor of sufficient size without compression or coagulation artifacts, which contributes to a more accurate histological evaluation.

Conclusion. Our experiments showed that CCB and CCE of a bladder tumor using carbon dioxide are feasible procedures that contribute to obtaining better biopsy material for pathomorphological examination, and also allows to evaluate the effect of low temperatures of carbon dioxide on the biopsy material (tumor tissue).

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About the authors

A. D. Damiev

FGAOU I.M. Sechenov First Moscow State Medical University

Author for correspondence.
Email: damievakhmed@mail.ru

Ph.D. student at the Institute for Urology and Human Reproductive Health of FGAOU I.M. Sechenov First Moscow State Medical University

Russian Federation, Moscow

E. V. Spot’

FGAOU I.M. Sechenov First Moscow State Medical University

Email: shpot@inbox.ru

urologist, oncologist, Ph.D., MD, Head of the Department of Oncourology, professor at the Institute for Urology and Human Reproductive Health of FGAOU I.M. Sechenov First Moscow State Medical University

Russian Federation, Moscow

G. N. Akopyan

FGAOU I.M. Sechenov First Moscow State Medical University

Email: docgagik@mail.ru

urologist, oncologist, Ph.D., MD, professor at Institute for Urology and Human Reproductive Health of FGAOU I.M. Sechenov First Moscow State Medical University

Russian Federation, Moscow

A. M. Dymov

FGAOU I.M. Sechenov First Moscow State Medical University

Email: alimdv@mail.ru

urologist, oncologist, Ph.D., MD, senior researcher at the Institute for Urology and Human Reproductive Health of FGAOU I.M. Sechenov First Moscow State Medical University

Russian Federation, Moscow

R. R. Kharcilava

FGAOU I.M. Sechenov First Moscow State Medical University

Email: dr.revaz@gmail.com

urologist, oncologist, Ph.D., Director of the “Praxi Medica” Medical Practice Training Center of FGAOU I.M. Sechenov First Moscow State Medical University

Russian Federation, Moscow

S. A. Yandiev

FGAOU I.M. Sechenov First Moscow State Medical University

Email: sylka06@mail.ru

1-year Ph.D. student at the Institute for Urology and Human Reproductive Health of FGAOU I.M. Sechenov First Moscow State Medical University

Russian Federation, Moscow

Kh. M. Ismailov

FGAOU I.M. Sechenov First Moscow State Medical University

Email: halilismailov2013@mail.ru

2-year resident at the Institute for Urology and Human Reproductive Health of FGAOU I.M. Sechenov First Moscow State Medical University

Russian Federation, Moscow

Yu. V. Lerner

FGAOU I.M. Sechenov First Moscow State Medical University

Email: julijalerner@inbox.ru

pathologist, physician of the first degree, assistant at the Department of Pathology named after A.I. Strukov of FGAOU I.M. Sechenov First Moscow State Medical University

Russian Federation, Moscow

K. A. Kammaev

FGAOU I.M. Sechenov First Moscow State Medical University

Email: kerim.kammaev95@mail.ru

endoscopist of the Department of Endoscopy of UKB No4 of FGAOU I.M. Sechenov First Moscow State Medical University

Russian Federation, Moscow

M-S. A. Gazimiev

FGAOU I.M. Sechenov First Moscow State Medical University

Email: gazimiev@yandex.ru

urologist, oncologist, Ph.D., MD, professor of the Institute for Urology and Human Reproductive Health, Director of National Medical Research Center of Urology on Urology, FGAOU I.M. Sechenov First Moscow State Medical University

Russian Federation, Moscow

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Supplementary files

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2. Fig. 1. Tumor fragments after transurethral resection

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3. Fig. 2. Fixation of a tissue fragment to the tip of the cryoprobe

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4. Fig. 3. Microphotograph of a bladder tumor. Hematoxylin and eosin staining, image length 50 μm (micrometers)

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5. Fig. 4. Fragment of endoscopic carboxycryobiopsy of a bladder tumor (a - stage of cryobiopsy of a bladder tumor, b - fragment of a bladder tumor fixed on the tip of a cryoprobe)

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6. Fig. 5. Fragment of endoscopic craboxycryoextraction of a bladder tumor (a - bringing the cryoprobe to the bladder tumor, b - stage of carboxycryoextraction of the bladder tumor, c - fragment of the bladder tumor fixed on the tip of the cryoprobe)

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7. Fig. 6. Endoscopic catheterization of TUR-biopsy of the MP tumor (a - bringing the loop to the MP tumor, b - stage of TUR-biopsy of the MP tumor)

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8. Fig. 7. Fragments of a bladder tumor (a - along the right side wall of the bladder (carboxycryobiopsy), b - along the left wall of the bladder (carboxycryoextraction), c - along the posterior wall of the bladder (TUR biopsy))

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9. Fig. 8. Microphotograph of a bladder tumor (carboxycryobiopsy). Hematoxylin and eosin staining, image length 50 μm (micrometers)

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10. Fig. 9. Microphotograph of a bladder tumor (carboxycryoextraction). Hemotoxylin and eosin staining, image length 200 μm (micrometers)

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11. Fig. 10 - Microphotograph of a bladder tumor (TUR biopsy). Hematoxylin and eosin staining, image length 50 μm (micrometers)

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