Background: Bladder cancer ranks as the 10th most common cancer globally. The diagnosis of bladder tumors typically involves cystoscopy. Objective: This study aimed to evaluate the sensitivity and specificity of cystoscopy in detecting bladder tumors within a surveillance program following a bladder cancer diagnosis. Design, Setting, and Participants: This study utilized recordings of cystoscopies conducted at the Department of Urology, Zealand University Hospital, between July 2021 and November 2022. Clinical observations were cross-referenced with pathological results or follow-up cystoscopies. Clinically negative cystoscopies were further scrutinized for potential overlooked tumors. Outcome Measurements and Statistical Analysis: Sensitivity and specificity of cystoscopy were assessed through ROC curve analysis. Results and Limitations: A total of 565 cystoscopies were recorded, with 135 indicating clinical positivity. Among 181 cystoscopies with clinically negative results that underwent a follow-up cystoscopy, 17 patients (9.4%) were subsequently diagnosed with bladder cancer, with the lesions identified in the initial cystoscopy. The sensitivity and specificity of cystoscopy in these cases were 81% and 73%, respectively. Conclusion: This trial underscores the underdiagnosis and undertreatment of bladder tumors within the current surveillance program. Additionally, aggressive malignant lesions may be overlooked, heightening the risk of disease progression. Therefore, it is recommended that cystoscopies be complemented by other diagnostic methods to ensure accurate diagnosis and proper patient treatment. Patient Summary: This study involved 316 patients who underwent video-recorded cystoscopies and subsequent follow-up. Of these patients, 181 initially exhibited no clinical signs of bladder cancer. However, upon reviewing the recorded cystoscopy, bladder cancer was identified in 17 patients (9.4%).
背景：膀胱癌是全球第十大常见癌症。膀胱肿瘤的诊断通常涉及膀胱镜检查。目的：本研究旨在评估膀胱镜检查在膀胱癌诊断后监测方案中检测膀胱肿瘤的敏感性和特异性。设计、设置与参与者：本研究分析了西兰大学医院泌尿外科于2021年7月至2022年11月期间进行的膀胱镜检查录像。临床观察结果与病理学结果或后续膀胱镜检查结果进行了交叉比对。对临床阴性的膀胱镜检查结果进行了进一步审查，以识别可能被忽视的肿瘤。结果测量与统计分析：通过ROC曲线分析评估膀胱镜检查的敏感性和特异性。结果与局限性：共记录了565例膀胱镜检查，其中135例显示临床阳性。在181例临床阴性结果并接受后续膀胱镜检查的患者中，有17例患者（9.4%）随后被诊断为膀胱癌，且病灶在初次膀胱镜检查中已被识别。在这些病例中，膀胱镜检查的敏感性和特异性分别为81%和73%。结论：本试验揭示了当前监测方案中膀胱肿瘤存在漏诊和治疗不足的问题。此外，侵袭性恶性病灶可能被忽视，从而增加了疾病进展的风险。因此，建议将膀胱镜检查与其他诊断方法结合使用，以确保准确诊断和患者得到适当治疗。患者总结：本研究涉及316名接受录像膀胱镜检查及后续随访的患者。其中181名患者最初未显示膀胱癌的临床迹象。然而，通过回顾录像膀胱镜检查，在17名患者（9.4%）中发现了膀胱癌。
Cystoscopy Accuracy in Detecting Bladder Tumors: A Prospective Video-Confirmed Study
肿瘤(癌症)患者之家