Wong Vincenzo K, Ganeshan Dhakshinamoorthy, Jensen Corey T, Devine Catherine E
Department of Abdominal Imaging, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA.
Cancers (Basel). 2021 Mar 19;13(6):1396. doi: 10.3390/cancers13061396.
Keyword searches of Medline, PubMed, and the Cochrane Library for manuscripts published in English, and searches of references cited in selected articles to identify additional relevant papers. Abstracts sponsored by various societies including the American Urological Association (AUA), European Association of Urology (EAU), and European Society for Medical Oncology (ESMO) were also searched.
Bladder cancer is the sixth most common cancer in the United States, and one of the most expensive in terms of cancer care. The overwhelming majority are urothelial carcinomas, more often non-muscle invasive rather than muscle-invasive. Bladder cancer is usually diagnosed after work up for hematuria. While the workup for gross hematuria remains CT urography and cystoscopy, the workup for microscopic hematuria was recently updated in 2020 by the American Urologic Association with a more risk-based approach. Bladder cancer is confirmed and staged by transurethral resection of bladder tumor. One of the main goals in staging is determining the presence or absence of muscle invasion by tumor which has wide implications in regards to management and prognosis. CT urography is the main imaging technique in the workup of bladder cancer. There is growing interest in advanced imaging techniques such as multiparametric MRI for local staging, as well as standardized imaging and reporting system with the recently created Vesicle Imaging Reporting and Data System (VI-RADS). Therapies for bladder cancer are rapidly evolving with immune checkpoint inhibitors, particularly programmed death ligand 1 (PD-L1) and programmed cell death protein 1 (PD-1) inhibitors, as well as another class of immunotherapy called an antibody-drug conjugate which consists of a cytotoxic drug conjugated to monoclonal antibodies against a specific target.
Bladder cancer is a complex disease, and its management is evolving. Advances in therapy, understanding of the disease, and advanced imaging have ushered in a period of rapid change in the care of bladder cancer patients.
通过对Medline、PubMed和Cochrane图书馆进行关键词检索，查找以英文发表的手稿，并检索所选文章中引用的参考文献，以识别其他相关论文。还检索了包括美国泌尿外科学会（AUA）、欧洲泌尿外科学会（EAU）和欧洲医学肿瘤学会（ESMO）等各种学会主办的摘要。
膀胱癌是美国第六大常见癌症，也是癌症治疗中费用最高的癌症之一。绝大多数是尿路上皮癌，非肌层浸润性癌比肌层浸润性癌更为常见。膀胱癌通常在对血尿进行检查后被诊断出来。虽然肉眼血尿的检查仍为CT尿路造影和膀胱镜检查，但美国泌尿外科学会于2020年最近更新了镜下血尿的检查方法，采用了更基于风险的方法。膀胱癌通过经尿道膀胱肿瘤切除术得以确诊和分期。分期的主要目标之一是确定肿瘤是否存在肌层浸润，这对治疗和预后具有广泛影响。CT尿路造影是膀胱癌检查中的主要成像技术。人们对用于局部分期的多参数MRI等先进成像技术以及最近创建的膀胱成像报告和数据系统（VI-RADS）的标准化成像和报告系统的兴趣与日俱增。膀胱癌的治疗方法正在迅速发展，免疫检查点抑制剂，特别是程序性死亡配体1（PD-L1）和程序性细胞死亡蛋白1（PD-1）抑制剂，以及另一类称为抗体药物偶联物的免疫疗法，该疗法由与针对特定靶点的单克隆抗体偶联的细胞毒性药物组成。
膀胱癌是一种复杂的疾病，其治疗方法正在不断发展。治疗方法的进步、对疾病的认识以及先进成像技术已经开启了膀胱癌患者护理快速变化的时期。
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