Background: The postoperative complication rate is 30–64% among patients undergoing muscle-invasive and recurrent high-risk non-muscle-invasive bladder cancer surgery. Preoperative risky alcohol use increases the risk. The aim was to evaluate the accuracy of markers for identifying preoperative risky alcohol. Methods: Diagnostic test sub-study of a randomized controlled trial (STOP-OP trial), based on a cohort of 94 patients scheduled for major bladder cancer surgery. Identification of risky alcohol use using Timeline Follow Back interviews (TLFB) were compared to the AUDIT–C questionnaire and three biomarkers: carbohydrate-deficient transferrin in plasma (P–CDT), phosphatidyl-ethanol in blood (B–PEth), and ethyl glucuronide in urine (U–EtG). Results: The correlation between TLFB and AUDIT–C was strong (ρ = 0.75), while it was moderate between TLFB and the biomarkers (ρ = 0.55–0.65). Overall, sensitivity ranged from 56 to 82% and specificity from 38 to 100%. B–PEth showed the lowest sensitivity at 56%, but the highest specificity of 100%. All tests had high positive predictive values (79–100%), but low negative predictive values (42–55%). Conclusions: Despite high positive predictive values, negative predictive values were weak compared to TLFB. For now, TLFB interviews seem preferable for preoperative identification of risky alcohol use.
背景：接受肌层浸润性和复发性高危非肌层浸润性膀胱癌手术的患者术后并发症发生率为30%至64%，术前危险饮酒行为会增加该风险。本研究旨在评估识别术前危险饮酒行为标志物的准确性。方法：作为一项随机对照试验（STOP-OP试验）的诊断测试子研究，纳入94例计划接受膀胱癌大手术的患者队列。通过时间线回溯访谈法识别危险饮酒行为，并与酒精使用障碍筛查量表简版问卷及三种生物标志物进行比较：血浆缺糖转铁蛋白、血液磷脂酰乙醇和尿液乙基葡萄糖醛酸苷。结果：时间线回溯访谈法与酒精使用障碍筛查量表简版问卷相关性较强（ρ=0.75），与生物标志物的相关性中等（ρ=0.55-0.65）。总体而言，灵敏度范围为56%至82%，特异度范围为38%至100%。血液磷脂酰乙醇灵敏度最低（56%），但特异度最高（100%）。所有检测均具有较高的阳性预测值（79%-100%），但阴性预测值较低（42%-55%）。结论：尽管阳性预测值较高，但与时间线回溯访谈法相比，阴性预测值较弱。目前，时间线回溯访谈法仍是术前识别危险饮酒行为的优选方法。
肿瘤(癌症)患者之家