Graber P
Département de chirurgie, Hôpital cantonal universitaire, Genève.
Schweiz Med Wochenschr. 1987 Dec 12;117(50):1987-92.
The epidemiologic data concerning the value of monosymptomatic microscopic hematuria as a screening test can be summarized in four points: 1. In an unselected population the chance of diagnosing serious urologic disease is about 5% and below 1% for tumors. 2. There is no difference between the result obtained by dip-stick or microscopic evaluation of the urinary sediment. The grade and duration of the symptom does not serve to select a group at risk, nor does age. 3. It is more realistic to admit 10% of non-classified microscopic hematurias than to classify the phenomenon with an unrealistic diagnosis. A benign disease may hide a serious one. 4. It is not certain that the early discovery of renal or bladder tumors makes a significant difference to prognosis in terms of survival. A detrimental effect of delayed treatment has been proved only for microinvasive bladder cancer.
关于单纯症状性镜下血尿作为一种筛查试验的价值，流行病学数据可归纳为四点：1. 在未经筛选的人群中，诊断出严重泌尿系统疾病的几率约为5%，诊断出肿瘤的几率低于1%。2. 试纸法检测结果与尿沉渣镜检结果无差异。症状的严重程度和持续时间以及年龄均不能用于筛选高危人群。3. 承认10%的未分类镜下血尿比用不切实际的诊断对该现象进行分类更为现实。良性疾病可能掩盖严重疾病。4. 肾或膀胱肿瘤的早期发现是否会对生存预后产生显著影响尚不确定。仅对微浸润性膀胱癌证明了延迟治疗具有有害影响。
