Froom P, Froom J, Ribak J
Department of Epidemiology, Sackler School of Medicine, University of Tel Aviv, Ramat Aviv, Israel.
J Clin Epidemiol. 1997 Nov;50(11):1197-200. doi: 10.1016/s0895-4356(97)00124-8.
Microscopic hematuria is common in asymptomatic adults, but the benefit of screening the general population for blood in the urine has not been established. On the other hand, most studies of referred patients with putatively asymptomatic microscopic hematuria have reported a 2-11% prevalence of urothelial malignancies, leading to the recommendation that all patients with microscopic hematuria be thoroughly investigated. Urinalysis is inexpensive and highly acceptable to the general population, but is neither a sensitive, nor specific test, and has poor predictive value for urothelial malignancies, and nephrological diseases. Furthermore the benefits of early detection of such diseases has not been established. We conclude that screening urinalysis cannot be recommended. Studies are needed to determine which constellation of findings primary physicians use to select patients for referral to centers with urological and nephrological expertise.
镜下血尿在无症状成年人中很常见，但对普通人群进行尿液潜血筛查的益处尚未得到证实。另一方面，大多数针对疑似无症状镜下血尿转诊患者的研究报告称，尿路上皮恶性肿瘤的患病率为2%至11%，因此建议对所有镜下血尿患者进行全面检查。尿液分析成本低廉且易于被普通人群接受，但它既不是一项敏感的检查，也不是特异性检查，对尿路上皮恶性肿瘤和肾脏疾病的预测价值较差。此外，早期发现此类疾病的益处尚未得到证实。我们得出结论，不建议进行尿液筛查。需要开展研究以确定初级医生根据哪些综合检查结果来选择患者转诊至具备泌尿外科和肾脏科专业知识的中心。
