Sengupta Shomik, Blute Michael L
Department of Urology, Mayo Clinic, Rochester, Minnesota 55905, USA.
Urology. 2006 Mar;67(3 Suppl 1):48-54; discussion 54-5. doi: 10.1016/j.urology.2006.01.041.
Superficial transitional cell carcinomas (TCC) of the urinary bladder, defined as those that are restricted to the mucosa or the lamina propria, represent a common condition with a wide spectrum of biologic significance. High-grade superficial TCC, particularly in the presence of lamina propria invasion, has a significant risk of occult or subsequent progression to muscle-invasive or metastatic disease. Such high-risk lesions merit aggressive therapy with repeat resection followed by intravesical therapy, usually in the form of bacille Calmette-Guérin. Criteria for failure of intravesical therapy are not well defined, but persistent cytologic or cystoscopic abnormalities at 6 months are worrisome. Salvage intravesical therapy may sometimes be successful, but early cystectomy should be strongly considered, especially in younger patients. Close surveillance of patients with high-risk superficial TCC is essential.
膀胱浅表性移行细胞癌（TCC），定义为局限于黏膜或固有层的肿瘤，是一种具有广泛生物学意义的常见病症。高级别浅表性TCC，尤其是存在固有层浸润时，有隐匿性或随后进展为肌层浸润性或转移性疾病的显著风险。此类高危病变值得积极治疗，通常先进行重复切除，随后进行膀胱内治疗，一般采用卡介苗的形式。膀胱内治疗失败的标准尚未明确界定，但6个月时持续存在的细胞学或膀胱镜检查异常令人担忧。挽救性膀胱内治疗有时可能成功，但应强烈考虑早期膀胱切除术，尤其是在年轻患者中。对高危浅表性TCC患者进行密切监测至关重要。
