Kausch I, Böhle A
Urologische Klinik und Poliklinik, Medizinische Universität zu Lübeck.
Urologe A. 2003 Jul;42(7):912-21. doi: 10.1007/s00120-003-0307-6. Epub 2003 Apr 11.
Although the current system of classifying bladder cancer by stage and histological grade is very useful, it is still difficult to predict the natural progression of the disease either with or without therapy. Cystoscopy and urine cytology are currently the gold standards in the monitoring and diagnosis of bladder cancer. Classical urine cytology is, however, at least in the diagnosis of G1-tumors, characterized by a relatively low sensitivity. In the last few years, the molecular biological investigation of the basic mechanisms involved in carcinogenesis has provided a host of markers which are of potential diagnostic value for bladder cancer. We provide a current, comprehensive review of the literature on bladder tumor markers and summarize their diagnostic and prognostic potential. At present, no diagnostic marker with a comparable sensitivity and specificity to cystoscopy exists, given that cystoscopy has never been evaluated. The combined analysis of several tumor markers seems to be the most promising approach as an adjunct to cystoscopy. Moreover, the increasing simplification of test systems will increase their acceptance by clinicians.
尽管目前根据分期和组织学分级对膀胱癌进行分类的系统非常有用，但无论是否接受治疗，预测该疾病的自然进展仍然很困难。膀胱镜检查和尿液细胞学检查是目前膀胱癌监测和诊断的金标准。然而，经典的尿液细胞学检查，至少在诊断G1肿瘤时，其特点是敏感性相对较低。在过去几年中，对致癌作用基本机制的分子生物学研究提供了许多对膀胱癌具有潜在诊断价值的标志物。我们对膀胱癌肿瘤标志物的文献进行了当前全面的综述，并总结了它们的诊断和预后潜力。目前，不存在与膀胱镜检查具有可比敏感性和特异性的诊断标志物，因为膀胱镜检查从未被评估过。几种肿瘤标志物的联合分析似乎是作为膀胱镜检查辅助手段最有前景的方法。此外，检测系统的日益简化将提高临床医生对它们的接受度。
