摘要
膀胱癌是我国临床上最常见的肿瘤之一,其中非肌层浸润性膀胱癌占全部膀胱肿瘤的75%~85%。目前常对患者行经尿道膀胱电切术,但术后复发率高,如何预防、预测膀胱癌的复发和进展一直是焦点问题。欧洲泌尿外科学会在2017年3月发布了的关于非肌层浸润性膀胱癌的最新指南并于2018年3月修订了部分内容。这篇文章主要对指南的诊断、复发与进展风险评估部分进行解读。诊断内容涉及初步诊断、影像学、尿细胞学及尿分子标志物检测、内镜检查、手术切除及病理检查等多个方面。复发与进展内容包括欧洲癌症研究治疗组织(EORTC)评分系统及西班牙泌尿肿瘤治疗组(CUETO)评分系统两大部分。
Bladder cancer is one of the most common tumors in China,among which non-muscle-invasive bladder cancer accounts for 75%~85% of all bladder tumors. Currently,transurethral resection of the bladder tumor(TURB) is often performed on patients,but the postoperative recurrence rate is high. How to prevent and predict the recurrence and progression of bladder cancer has always been a focus issue. The European Association of Urology issued the Guidelines for Non-muscle-invasive Bladder Cancer in March 2017,and revised part in March 2018.This article focuses on diagnosis,prediction and evaluation of disease recurrence and progression.The diagnosis includes preliminary diagnosis,imaging,urinary cytology,urinary molecular marker tests,endoscopy,tumour resection,pathology report and so on.European Organization for Research and Treatment of Cancer(EORTC) scoring system and the Club Urológico Espa?ol de Tratamiento Oncológico(CUETO) scoring system are the two widely used modes of prediction and evaluation of disease recurrence and progression.
引文
[1]那彦群.中国泌尿外科疾病诊断治疗指南手册[M].北京:人民卫生出版社, 2014.
[2]李宁忱.《膀胱癌诊断治疗指南》解读——膀胱癌的治疗[J].中华医学信息导报, 2008, 23(6):21-22.
[3]European Association of Urology. EAU Guidelines:Nonmuscle-invasive Bladder Cancer. presented at the EAU Annual Congress Copenhagen 2018[EB/OL]. http://uroweb.org/guideline/non-muscle-invasive-bladder-cancer/#11.
[4]中国研究型医院学会泌尿外科学专业委员会,中国医疗保健国际交流促进会泌尿健康促进分会,中国医疗保健国际交流促进会循证医学分会.中国良性前列腺增生症经尿道等离子双极电切术治疗指南(2018标准版)[J].中华医学杂志, 2018, 98(20):1549-1560.
[5]中国研究型医院学会泌尿外科学专业委员会,中国医疗保健国际交流促进会泌尿健康促进分会,中国医疗保健国际交流促进会循证医学分会.中国良性前列腺增生症经尿道等离子双极电切术治疗指南(2018简化版)[J].中国循证医学杂志, 2018, 18(6):543-546.
[6]靳英辉,曾宪涛,刘同族,等.非肌层浸润性膀胱癌治疗与监测循证临床实践指南研究方案[J].中国研究型医院,2018, 5(3):42-51.