膀胱癌症的诊断和预后非侵袭性标志物

摘要(中文译文)

膀胱癌是一种常见恶性肿瘤，复发率高且发病率显著，因此需要准确的诊断和预后工具。尽管膀胱镜检查和经尿道膀胱肿瘤电切术（TURBT）仍是参考标准，但这些方法具有侵入性，并受限于采样误差和分期不足。因此，人们对非侵入性生物标志物的兴趣日益增长，包括基于尿液的检测、基于血液的标志物以及影像学衍生参数。在这些生物标志物中，多参数磁共振成像（mpMRI），特别是结合膀胱影像报告和数据系统（VI-RADS），已成为用于局部分期和风险分层的稳健非侵入性影像生物标志物。近期证据表明，mpMRI在预测治疗反应和复发方面发挥作用，尤其是在新辅助治疗的背景下。本综述全面概述了膀胱癌当前的非侵入性诊断和预后生物标志物，特别侧重于影像生物标志物。我们讨论了它们的临床效用、局限性以及未来整合到多模式决策框架中的前景。

Abstract

Bladder cancer is a common malignancy with high recurrence rates and significant morbidity, necessitating accurate diagnostic and prognostic tools. Although cystoscopy and transurethral resection of bladder tumor (TURBT) remain reference standards, these approaches are invasive and limited by sampling errors and understaging. Consequently, there is growing interest in non-invasive biomarkers, including urine-based assays, blood-based markers, and imaging-derived parameters. Among these biomarkers, multiparametric magnetic resonance imaging (mpMRI), particularly with the Vesical Imaging Reporting and Data System (VI-RADS), has emerged as a robust non-invasive imaging biomarker for local staging and risk stratification. Recent evidence suggests that mpMRI plays a role in predicting treatment response and recurrence, particularly in the context of neoadjuvant therapy. This review provides a comprehensive overview of current non-invasive diagnostic and prognostic biomarkers in bladder cancer, with a particular emphasis on imaging biomarkers. We discuss their clinical utility, limitations, and future integration into multimodal decision-making frameworks.

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