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[非肌层浸润性膀胱癌的术后护理]

[Aftercare of non-muscle invasive bladder cancer].

作者信息

Schulz G B, Schlenker B, Stief C G

机构信息

Urologische Klinik und Poliklinik, Klinikum der Universität München, Campus Großhadern, Marchioninistr. 15, 81377, München, Deutschland.

出版信息

Urologe A. 2019 Aug;58(8):943-952. doi: 10.1007/s00120-019-0956-8.

Abstract

Tumor follow-up in patients with non-muscle invasive bladder cancer (NMIBC) is a weighing up between the morbidity associated with invasive diagnostics and the risk of tumor recurrence and especially progression. The risk stratification into low, intermediate, and high-risk tumors enables a risk-adapted follow-up. For individual estimation of the risk of progression and recurrence, risk calculators should be used. Follow-up is still based on cystoscopy, which is recommended lifelong for high and intermediate-risk tumors and for up to 5 tumor-free years for low-risk tumors. Urine cytology has a high sensitivity and specificity for high-risk tumors and is recommended in the follow-up care. There is currently no recommendation for any commercially available urinary marker due to inadequate evidence. For the clarification of synchronous and metachronous tumors of the upper urinary tract computed tomography (CT) urography or alternatively magnetic resonance (MR) urography is recommended.

摘要

非肌层浸润性膀胱癌(NMIBC)患者的肿瘤随访是在侵入性诊断相关的发病率与肿瘤复发尤其是进展风险之间进行权衡。将肿瘤分为低、中、高风险进行分层,有助于进行风险适应性随访。为了对进展和复发风险进行个体评估,应使用风险计算器。随访仍以膀胱镜检查为基础,对于高风险和中风险肿瘤建议终身进行,对于低风险肿瘤建议在无肿瘤的情况下进行长达5年的随访。尿液细胞学检查对高风险肿瘤具有较高的敏感性和特异性,建议在后续护理中使用。由于证据不足,目前对于任何商用尿液标志物均无推荐。为了明确上尿路的同步和异时肿瘤,建议进行计算机断层扫描(CT)尿路造影或磁共振(MR)尿路造影。

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