膀胱癌早诊早治专家共识（2024年版）

doi:10.19401/j.cnki.1007-3639.2024.06.009

摘要/Abstract

摘要：

膀胱癌是常见的泌尿系统恶性肿瘤之一，严重威胁着中国人民的生命健康。近年来，随着人均寿命的延长，以及人口老龄化的加速，膀胱癌的发病率和死亡率呈逐年上升趋势。提高早期膀胱癌的检出率并进行及时有效的治疗，既可改善患者的预后和生存质量，又能减轻其经济负担，但目前中国尚缺乏膀胱癌早诊早治的统一规范。因此，中国肿瘤医院泌尿肿瘤协作组的相关专家，根据近年的膀胱癌国内外指南、研究进展和临床实践经验，通过专家会议讨论、德尔菲问卷调查等形式，对专家意见进行调查汇总、归纳整理和修改完善，最终形成《膀胱癌早诊早治专家共识（2024年版）》。希望通过本共识，推进中国膀胱癌早诊早治的规范化，也为相关临床工作者提供相应的指导意见和规范依据。本共识已在国际实践指南注册与透明化平台（Practice guideline REgistration for transPAREncy，PREPARE）上注册，注册号为PREPARE-2024CN458。

关键词: 膀胱癌, 早诊早治, 共识

Abstract:

Bladder cancer is one of the common cancers of urinary system, which seriously threatens the life and health of Chinese population. In recent years, with the extension of life expectancy and the acceleration of aging, the incidence and mortality rates of bladder cancer are increasing year by year. Enhancing the detection rate of early bladder cancer followed by prompt and effective treatment can not only improve the prognosis and quality of life of patients, but also reduce their economic burden. However, there is still a lack of standardization for early diagnosis and treatment of bladder cancer in China. Therefore, based on the recent guidelines, research and clinical practice experience of bladder cancer, clinical experts in Urologic Chinese Oncology Group summarized and refined the opinions from expert meeting and Delphi questionnaire survey, and finally developed “expert consensus on early diagnosis and treatment of bladder cancer (2024 edition)”. We hope that this consensus will promote the standardization for early diagnosis and treatment of bladder cancer in China, and provide corresponding guidance and standardized criteria for urologic oncologist. The consensus has been registered on Practice guideline REgistration for transPAREncy (PREPARE) with the registration number PREPARE-2024CN458.

Key words: Bladder cancer, Early diagnosis and treatment, Consensus

中图分类号:

R737.14

中国肿瘤医院泌尿肿瘤协作组. 膀胱癌早诊早治专家共识（2024年版）[J]. 中国癌症杂志, 2024, 34(6): 607-618.

Urologic Chinese Oncology Group. Expert consensus on early diagnosis and treatment of bladder cancer (2024 edition)[J]. China Oncology, 2024, 34(6): 607-618.

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证据级别及推荐强度分级	内容及解释
证据质量分级
高	基于高水平前瞻性随机对照临床试验（randomized control trial，RCT）或严谨的meta分析，研究结果具有高度可信性和推广性
中	基于低水平随机临床试验或设计良好的非对照临床试验或队列研究或一般质量的meta分析，可信度一般
低	基于病例对照研究、回顾性研究、亚组分析，可信度较低
极低	非对照的单臂临床研究、病例报告、基于经验且未经严格论证的专家意见
推荐强度分级
强推荐	证据级别较高，专家一致共识或基本一致共识，予以强推荐
一般推荐	证据级别较低，专家基本一致共识或无共识，予以一般推荐

分组	描述
低危组	同时具备原发、单发、Ta/T1 LG/G1、直径<3 cm，无CIS、年龄<70岁
	无CIS的原发Ta LG/G1肿瘤，且临床相关危险因素^*最多包含1种
中危组	不符合低危、高危和极高危组条件，且无CIS
高危组	T1 HG/G3肿瘤，无CIS，且不符合极高危组条件
	肿瘤存在CIS，且不符合极高危组条件
	Ta LG/G2或T1 G1，无CIS，且包含3种临床相关危险因素
	Ta HG/G3或T1 LG，无CIS，且包含至少2种临床相关危险因素
	T1 G2，无CIS，且包含至少1种临床相关危险因素
极高危组	Ta HG/G3，有CIS，且包含3种临床相关危险因素
	T1 G2，有CIS，且包含至少2种临床相关危险因素
	T1 HG/G3，有CIS，且包含至少1种临床相关危险因素
	T1 HG/G3，CIS，且包含3种临床相关危险因素
	前列腺尿道部伴有CIS
	尿路上皮癌伴不良组织学变异亚型^**
	伴有血管淋巴管侵犯