膀胱癌早期检测项目的基本原理。

Rationale for an early detection program for bladder cancer.

作者信息

Khochikar Makarand V

机构信息

Department of Uro-oncology, Siddhi Vinayak Ganapati Cancer Hospital, Miraj, India.

出版信息

Indian J Urol. 2011 Apr;27(2):218-25. doi: 10.4103/0970-1591.82841.

DOI:10.4103/0970-1591.82841

PMID:21814313

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3142833/

Abstract

INTRODUCTION

A total of 356,557 new cases were diagnosed annually worldwide in 2009, it was estimated that 52,810 new patients were to be diagnosed with bladder cancer and there were 10,180 projected deaths from the disease in the USA. Despite being the fourth commonest cancer in men, we do not have an early detection/screening program for bladder cancer. The review was aimed at looking at the evidence for the rationale for an early detection program for bladder cancer.

MATERIALS AND METHODS

A detailed search on bladder cancer epidemiology, diagnosis, pathology, tumor markers, treatment outcomes, screening, morbidity and mortality of bladder cancer was carried out on Pubmed central/Medline. Original articles, review articles, monograms, book chapters on bladder cancer, text books on urological oncology, oncology and urology were reviewed. The latest information for new articles before publication was last accessed in June 2010.

DISCUSSION AND CONCLUSIONS

Bladder cancer is the fourth commonest cancer in men, the annual death rate from this disease is significant and every year there is an increase in its incidence globally. The prognosis of bladder cancer is stage and grade dependent; the lower the stage (T2 or less) the better is the survival. Delay in the diagnosis and treatment does alter the overall outcome. Therefore, there is a clear need for early detection of bladder cancer and screening program. Although we do not have an ideal marker for bladder cancer, it is time we maximize the potential of markers such as UroVysion, NMP22 along with cytology to start such a program. May be as a first step the early detection and screening program could be started in high-risk population. It is not worth waiting till we find the best marker as it would be unfair to our patients. The fear of unnecessary tests and treatment in bladder cancer after its detection in screening program is without any substance. The cost-effectiveness of such a program is certainly comparable to that is used for colon or breast and for prostate as well.

摘要

引言

2009年全球每年共诊断出356,557例新病例，据估计，美国有52,810名新患者将被诊断出患有膀胱癌，且该疾病预计导致10,180人死亡。尽管膀胱癌是男性中第四常见的癌症，但我们并没有针对膀胱癌的早期检测/筛查计划。本综述旨在研究膀胱癌早期检测计划的理论依据的证据。

材料与方法

在PubMed Central/Medline上对膀胱癌的流行病学、诊断、病理学、肿瘤标志物、治疗结果、筛查、发病率和死亡率进行了详细搜索。对膀胱癌的原始文章、综述文章、专论、书籍章节、泌尿肿瘤学教科书、肿瘤学和泌尿学教科书进行了综述。最新的未发表新文章信息最后一次访问时间为2010年6月。

讨论与结论

膀胱癌是男性中第四常见的癌症，该疾病的年死亡率很高，并且其全球发病率每年都在上升。膀胱癌的预后取决于分期和分级；分期越低（T2或更低），生存率越好。诊断和治疗的延迟确实会改变总体结果。因此，显然需要早期检测膀胱癌并开展筛查计划。尽管我们没有理想的膀胱癌标志物，但现在是时候充分发挥诸如UroVysion、NMP22等标志物以及细胞学检查的潜力来启动这样一个计划了。也许作为第一步，可以在高危人群中启动早期检测和筛查计划。等到找到最佳标志物再行动是不值得的，因为这对我们的患者不公平。在筛查计划中检测出膀胱癌后对不必要检查和治疗的担忧是毫无根据的。这样一个计划的成本效益肯定与用于结肠癌、乳腺癌以及前列腺癌的计划相当。