膀胱癌的规范化诊治（134页）.ppt

膀胱癌的规范化诊治;Siegel RL, et al. CA CANCER J CLIN 2015;00:00–00;;Five-Year Relative Survival Rates for Selected Cancers by Race and Stage at Diagnosis, United States, 2004 to 2010.;我国膀胱癌发病率低于欧美等西方国家 近年来发病率呈明显上升趋势 男性发病率为女性3-4倍 城市发病率高于农村 对分期相同的膀胱癌，女性的预后比男性差 不能完全解释为吸烟习惯和职业因素 性激素可能是导致这一结果的重要原因 ;危险因素;分子机制;膀胱癌的分类;T (原发肿瘤);;9、 人的价值，在招收诱惑的一瞬间被决定。*** 10、低头要有勇气，抬头要有低气。**** 11、人总是珍惜为得到。***** 12、人乱于心，不宽余请。**** 13、生气是拿别人做错的事来惩罚自己。***** 14、抱最大的希望，作最大的努力。**** 15、一个人炫耀什么，说明他内心缺少什么。。***** 16、业余生活要有意义，不要越轨。*** 17、一个人即使已登??顶峰，也仍要自强不息。****;膀胱癌的诊断;早期检测与症状;体格检查;影像学检查;2021/4/26;;尿脱落细胞学;尿液膀胱癌标记物;P16(红)位点,17染色体着丝粒(绿);膀胱镜检查和活检;诊断性经尿道电切术;TURBT的问题;荧光膀胱镜检查;The value of FC and NBI for improvement of outcome in relation to progression rate and survival remains to be demonstrated.;非肌层浸润性膀胱癌复发进展的风险评估;非肌层浸润性膀胱尿路上皮癌恶性程度分级系统;对于非肌层浸润性膀胱肿瘤，可通过EORTC（European Organization for Research and Treatment of Cancer）评分系统评估TUR-BT术后近期和远期复发进展概率;非肌层浸润膀胱癌复发风险及预后（EORTC scoring model);EAU guideline 2016;;Spanish Urological Oncology Group(CUETO) scoring model predicting risk of disease recurrence and progression in pts with BCG instillation ;非肌层浸润膀胱癌复发进展风险分层;非肌层浸润性膀胱癌的治疗;非肌层浸润性膀胱癌的手术治疗;经尿道膀胱肿瘤切除术---TURBT;;二次电切减少肿瘤残留率;二次电切提高肿瘤分期准确性;; 二次经尿道电切术;经尿道激光手术;术后辅助治疗;Fig. 1 – Smoking status significantly influences the recurrence-free survival of patients with NMIBC. After a mean follow-up of 2.5 yr, 46.8% of the ex-smokers and current smokers were recurrence free compared with 62.3% of the nonsmokers (log-rank test; p = 0.005).;术后膀胱灌注治疗;术后膀胱灌注化疗;Sylvester RJ, et al. Eur Urol 2016;69:231-244;Time to first recurrence;Sylvester RJ, et al. Eur Urol 2016;69:231-244;Sylvester RJ, et al. Eur Urol 2016;69:231-244;Question 1: After one immediate instillation, can additional intravesical chemotherapy reduce the recurrence rate in patients with multiple tumors?;Question 1: After one immediate instillation, can additional intravesical chemotherapy reduce the recurrence rate in patients with multiple tumors?;Question 2: If further intra