Dobrowolska-Glazar Barbara, Glazar Wojciech, Dobrowolski Zygmunt, Lipczyński Wacław
Katedra i Klinika Urologii Collegium Medicum Uniwersytetu Jagiellońskiego, Kraków.
Przegl Lek. 2010;67(7):479-83.
Bladder cancer is one of the most prevalent cancers worldwide. Non-muscle invasive bladder cancer has a 70% rate of recurrence. Its biological tendency to recur and progress mandates close follow-up for the early detection of recurrent tumors. Urine cytology is the most widely used noninvasive test to detect urothelial tumors. However, it is limited by its low sensitivity. On the other hand, cystoscopy is the gold standard procedure to follow patients with a history of bladder cancer but this test is invasive and expensive. Therefore, there is a real need to develop new tests that can be used in bladder cancer surveillance. In recent years there is a constant effort to find a better non-invasive marker for bladder cancer. Many markers for the detection of bladder cancers have been tested and almost all urinary markers reported are better than cytology with regard to sensitivity, but they score lower in specificity. Our knowledge of molecular pathways in bladder cancer is growing and new methods of marker development emerge, but the perfect marker is still to be found. Currently, there are not clinically usable molecular markers that can guide us in diagnosis or surveillance, nor guide us in lowering the frequency of urethrocystoscopy in bladder cancer. This article reports some of the more prominent urine markers in use today.
膀胱癌是全球最常见的癌症之一。非肌层浸润性膀胱癌的复发率为70%。其复发和进展的生物学倾向要求密切随访以早期发现复发肿瘤。尿细胞学检查是检测尿路上皮肿瘤最广泛使用的非侵入性检查。然而，其敏感性较低。另一方面，膀胱镜检查是膀胱癌患者随访的金标准，但该检查具有侵入性且费用高昂。因此，确实需要开发可用于膀胱癌监测的新检查。近年来，人们一直在努力寻找更好的膀胱癌非侵入性标志物。许多用于检测膀胱癌的标志物已经过测试，几乎所有报道的尿液标志物在敏感性方面都优于细胞学检查，但在特异性方面得分较低。我们对膀胱癌分子途径的了解不断增加，新的标志物开发方法不断涌现，但完美的标志物仍有待发现。目前，尚无临床可用的分子标志物能指导我们进行诊断或监测，也无法指导我们降低膀胱癌尿道膀胱镜检查的频率。本文报道了目前一些较为突出的尿液标志物。
