MRI表观扩散系数值和血清炎症指标(SII、PLR、NLR)在膀胱癌浸润性评估中的 应用价值

The Value of MRI Apparent Diffusion Coefficient and Serum Inflammatory Markers (SII, PLR, NLR) in the Assessment of Bladder Cancer Invasiveness

摘要: 膀胱癌在男性泌尿系统肿瘤中发病率最高，目前研究发现有多种危险的致病因素。临床上根据其病理金标准将其分为尿路上皮癌、鳞状细胞癌、腺癌及其他特殊类型癌；其中常见为尿路上皮癌，根据其是否侵犯肌层分为浸润性癌和非浸润性癌两大类，两者分型在治疗方案及预后方面均存在差异。目前，经尿道的膀胱镜活检仍然是诊断膀胱癌精确诊断的金标准，但由于侵入性操作，过度依赖操作人员的经验，有时存在误报率较高的情况。为突破传统膀胱癌分型对病理学的依赖，提高早期患者诊断率，降低侵入性检查对患者的创伤，现为了早期发现病灶，识别病灶的良恶性，为临床医师诊断及治疗方案提出可靠依据，将影像技术与检验技术结合，该体系通过整合高分辨率影像特征与特异性血清分子标记，旨在实现对非浸润性与浸润性膀胱癌的精准鉴别。本文就目前血清学及影像学指标在膀胱癌患者中的临床应用的现状及其未来发展做一综述。

Abstract: Bladder cancer has the highest incidence among male urological system tumors. Current research has identified multiple risk factors. Clinically, based on the pathological gold standard, bladder cancer is classified into urothelial carcinoma, squamous cell carcinoma, adenocarcinoma, and other special types, among which urothelial carcinoma is the most common. According to whether it invades the muscle layer, it is divided into invasive and non-invasive cancer, with differences in treatment approaches and prognosis between the two types. Currently, transurethral cystoscopic biopsy remains the gold standard for the accurate diagnosis of bladder cancer; however, due to its invasive nature and heavy dependence on the operator’s experience, there is sometimes a relatively high rate of misreporting. To overcome the dependence of traditional bladder cancer typing on pathology, improve early diagnosis rates, and reduce the trauma of invasive examinations for patients, imaging technology combined with laboratory testing has been proposed to enable early detection of lesions, distinguish between benign and malignant lesions, and provide clinicians with reliable bases for diagnosis and treatment. This system integrates high-resolution imaging features with specific serum molecular markers to achieve precise differentiation between non-invasive and invasive bladder cancer. This article reviews the current clinical application and future development of serum and imaging indicators in bladder cancer patients.