Department of Urology, Ludwig-Maximilians-University, Klinikum Grosshadern, Munich, Germany.
Eur Urol. 2011 Sep;60(3):484-92. doi: 10.1016/j.eururo.2011.05.053. Epub 2011 Jun 12.
Bladder cancer diagnosis and surveillance includes cystoscopy and cytology. The limitation of urinary cytology is its low sensitivity for low-grade recurrences. As of now, six urine markers are commercially available to complement cystoscopy in the detection of bladder cancer. Several promising tests are under investigation.
In this nonsystematic review, we summarize the existing data on commercially available and promising investigational urine markers for the detection of bladder cancer.
A PubMed search was carried out. We reviewed the recent literature on urine-based markers for bladder cancer. Articles were considered between 1997 and 2011. Older studies were included selectively if historically relevant.
Although different studies have shown the superiority of urine markers regarding sensitivity for bladder cancer detection as compared with cytology, none of these tests is ideal and can be recommended unrestrictedly.
Urine markers have been studied extensively to help diagnose bladder cancer and thereby decrease the need for cystoscopy. However, no marker is available at present that can sufficiently warrant this. Several urinary markers have higher but still insufficient sensitivity compared with cytology. Urinary cytology or markers cannot safely replace cystoscopy in this setting. To identify an optimal marker that can delay cystoscopy in the diagnosis of bladder cancer, large prospective and standardized studies are needed.
膀胱癌的诊断和监测包括膀胱镜检查和细胞学检查。尿液细胞学检查的局限性在于其对低级别复发的敏感性较低。目前，有六种尿液标志物可用于在膀胱癌检测中补充膀胱镜检查。还有一些很有前途的检测方法正在研究中。
在本次非系统性综述中，我们总结了目前可用于商业用途和有前途的膀胱癌检测尿液标志物的现有数据。
进行了一次 PubMed 搜索。我们复习了关于膀胱癌基于尿液的标志物的最新文献。文章的时间跨度为 1997 年至 2011 年。如果在历史上具有相关性，则会选择性地收录更早期的研究。
尽管不同的研究已经表明，与细胞学相比，尿液标志物在膀胱癌检测的敏感性方面具有优越性，但这些检测方法都不是理想的，不能无限制地推荐使用。
已经广泛研究了尿液标志物以帮助诊断膀胱癌，从而减少对膀胱镜检查的需求。然而，目前还没有一种标志物能够充分证明这一点。与细胞学相比，几种尿液标志物的敏感性更高，但仍不够理想。在这种情况下，尿液细胞学或标志物不能安全地替代膀胱镜检查。为了确定一种可用于诊断膀胱癌、能延迟膀胱镜检查的最佳标志物，还需要开展大型的前瞻性和标准化研究。
