Grossman H B
Department of Urology, The University of Texas M.D. Anderson Cancer Center, Houston 77030-4095, USA.
Semin Urol Oncol. 1998 Feb;16(1):17-22.
Superficial bladder cancer is characterized by a high incidence of recurrence and a low risk of progression. Cystoscopy has been the mainstay for bladder cancer detection with additional information provided by urine cytology. Several new markers, including the BTA series of markers, NMP22 and FDP, have been approved for clinical use; numerous others continue to be evaluated. Markers help to detect clinically occult bladder cancer and to increase the interval of cystoscopic evaluation. The former indication emphasizes specificity (if a marker has high specificity, the marker-directed biopsies are frequently positive) and the latter, sensitivity (if a marker has high sensitivity, there is a low risk of deferring cystoscopy when bladder cancer is present). Because no marker or combination of markers has 100% sensitivity and 100% specificity, the selection of markers for clinical use rests on the desired objective and the performance characteristics of the available assays.
浅表性膀胱癌的特点是复发率高、进展风险低。膀胱镜检查一直是膀胱癌检测的主要手段，尿细胞学检查可提供额外信息。包括BTA系列标志物、NMP22和FDP在内的几种新标志物已获批用于临床；还有许多其他标志物仍在评估中。标志物有助于检测临床上隐匿的膀胱癌，并延长膀胱镜检查评估的间隔时间。前一种指征强调特异性（如果一种标志物具有高特异性，那么基于该标志物的活检通常呈阳性），而后一种指征强调敏感性（如果一种标志物具有高敏感性，那么在存在膀胱癌时推迟膀胱镜检查的风险就较低）。由于没有一种标志物或标志物组合具有100%的敏感性和100%的特异性，临床使用标志物的选择取决于期望的目标和现有检测方法的性能特征。
