Lokeshwar Vinata B, Habuchi Tomonori, Grossman H Barton, Murphy William M, Hautmann Stefan H, Hemstreet George P, Bono Aldo V, Getzenberg Robert H, Goebell Peter, Schmitz-Dräger Bernd J, Schalken Jack A, Fradet Yves, Marberger Michael, Messing Edward, Droller Michael J
Department of Urology, University of Miami, Miami, Florida 33101, USA.
Urology. 2005 Dec;66(6 Suppl 1):35-63. doi: 10.1016/j.urology.2005.08.064.
This is the first of 2 articles that summarize the findings of the International Consensus Panel on cytology and bladder tumor markers. The objectives of our panel were to reach a consensus on the areas where markers are needed, to define the attributes of an ideal tumor marker, and to identify which marker(s) would be suitable for diagnosis and/or surveillance of bladder cancer. Our panel consisted of urologists and researchers from Europe, Asia, and the United States who reviewed original articles, reviews, and book chapters on individual bladder tumor markers published in the English language mainly using the PubMed search engine. Panel members also met during 3 international meetings to write recommendations regarding bladder tumor markers. The panel found that the most practical use of noninvasive tests is to monitor bladder cancer recurrence, thereby reducing the number of surveillance cystoscopies performed each year. Markers also may be useful in the screening of high-risk individuals for early detection of bladder cancer. However, more prospective studies are needed to strengthen this argument. Case-control and cohort studies show that several markers have a higher sensitivity to detect bladder cancer. However, cytology is the superior marker in terms of specificity, although some markers in limited numbers of studies have shown specificity equivalent to that of cytology. Our panel believes that several bladder tumor markers are more accurate in detecting bladder cancer than prostate-specific antigen (PSA) is in detecting prostate cancer. However, bladder tumor markers are held to a higher standard than PSA. Therefore, use of bladder tumor markers in the management of patients with bladder cancer will require the willingness of both urologists and clinicians to accept them.
这是总结国际细胞学与膀胱肿瘤标志物共识小组研究结果的两篇文章中的第一篇。我们小组的目标是就需要标志物的领域达成共识，定义理想肿瘤标志物的属性，并确定哪些标志物适用于膀胱癌的诊断和/或监测。我们的小组由来自欧洲、亚洲和美国的泌尿科医生和研究人员组成，他们主要使用PubMed搜索引擎查阅了以英文发表的关于各个膀胱肿瘤标志物的原始文章、综述和书籍章节。小组成员还在3次国际会议期间会面，撰写关于膀胱肿瘤标志物的建议。小组发现，非侵入性检测最实际的用途是监测膀胱癌复发，从而减少每年进行的监测性膀胱镜检查的次数。标志物在筛查高危个体以早期发现膀胱癌方面可能也有用。然而，需要更多的前瞻性研究来支持这一观点。病例对照研究和队列研究表明，几种标志物在检测膀胱癌方面具有更高的敏感性。然而，就特异性而言，细胞学是更优的标志物，尽管在少数研究中一些标志物显示出与细胞学相当的特异性。我们小组认为，几种膀胱肿瘤标志物在检测膀胱癌方面比前列腺特异性抗原（PSA）检测前列腺癌更准确。然而，膀胱肿瘤标志物的标准比PSA更高。因此，在膀胱癌患者的管理中使用膀胱肿瘤标志物将需要泌尿科医生和临床医生都愿意接受它们。
