Hee Tan Guan, Shah Shamsul Azhar, Ann Ho Sue, Hemdan Siti Nurhafizah, Shen Lim Chun, Al-Fahmi Abdul Galib Nurudin, Singam Praveen, Chee Kong Christopher Ho, Hong Goh Eng, Bahadzor Badrulhisham, Zainuddin Zulkifli Md
Urology Unit, Department of Surgery, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia E-mail :
Asian Pac J Cancer Prev. 2013;14(11):6327-30. doi: 10.7314/apjcp.2013.14.11.6327.
Haematuria is a common presentation of bladder cancer and requires a full urologic evaluation. This study aimed to develop a scoring system capable of stratifying patients with haematuria into high or low risk groups for having bladder cancer to help clinicians decide which patients need more urgent assessment. This cross- sectional study included all adult patients referred for haematuria and subsequently undergoing full urological evaluation in the years 2001 to 2011. Risk factors with strong association with bladder cancer in the study population were used to design the scoring system. Accuracy was determined by the area under the receiver operating characteristic (ROC) curve. A total of 325 patients with haematuria were included, out of which 70 (21.5%) were diagnosed to have bladder cancer. Significant risk factors associated with bladder cancer were male gender, a history of cigarette smoking and the presence of gross haematuria. A scoring system using 4 clinical parameters as variables was created. The scores ranged between 6 to 14, and a score of 10 and above indicated high risk for having bladder cancer. It was found to have good accuracy with an area under the ROC curve of 80.4%, while the sensitivity and specificity were 90.0% and 55.7%, respectively. The scoring system designed in this study has the potential to help clinicians stratify patients who present with haematuria into high or low risk for having bladder cancer. This will enable high-risk patients to undergo urologic assessment earlier.
血尿是膀胱癌的常见表现，需要进行全面的泌尿外科评估。本研究旨在开发一种评分系统，能够将血尿患者分为膀胱癌高风险或低风险组，以帮助临床医生确定哪些患者需要更紧急的评估。这项横断面研究纳入了2001年至2011年间所有因血尿转诊并随后接受全面泌尿外科评估的成年患者。研究人群中与膀胱癌有强关联的危险因素被用于设计评分系统。准确性通过受试者操作特征（ROC）曲线下面积来确定。共纳入325例血尿患者，其中70例（21.5%）被诊断患有膀胱癌。与膀胱癌相关的显著危险因素为男性、吸烟史和肉眼血尿的存在。创建了一个以4个临床参数为变量的评分系统。分数范围为6至14分，10分及以上表明患膀胱癌的风险高。结果发现该评分系统具有良好的准确性，ROC曲线下面积为80.4%，而敏感性和特异性分别为90.0%和55.7%。本研究设计的评分系统有可能帮助临床医生将出现血尿的患者分为患膀胱癌的高风险或低风险组。这将使高风险患者能够更早地接受泌尿外科评估。
