背景：近年来，在非肌层浸润性膀胱癌(NMIBC)的随访中,为了减少膀胱镜检查次数,已经开发了不同的尿液标志物,如膀胱Epicheck®.
目的：对膀胱Epicheck®及其在随访和检测NMIBC复发中的临床应用进行系统评价。
方法：基于PubMed文献检索的系统评价，根据PRISMA和Quadas-2标准，WebofScience和Scopus数据库将持续到2023年10月。灵敏度(Se),特异性（Sp），计算标志物的阳性预测值(PPV)和阴性预测值(NPV)。通过曲线下面积(AUC)评价诊断性能。
结果：分析了15项研究（n=3761），包括86.7%的前瞻性研究。在病人系列中，53.2%以前曾接受膀胱内滴注。复发检测中生物标志物的平均硒根据肿瘤分级而变化(87.9%-高等级/HGvs.44.9%-低等级/LG，分别)。它们的加权平均Se和Sp分别为71.6%和84.5%，分别。平均复发率为29.1%。加权平均PPV和NPV分别为56.4%和92.8%(97.7%非LG)，分别。平均AUC为85.63%。
结论：膀胱Epicheck®是NMIBC随访中有用的尿标志物，在复发的检测中，硒和净现值显著高，特别是在HG疾病的情况下。它的使用可以减少NMIBC随访中所需的膀胱镜检查次数，改善患者的生活质量，并可能增加健康经济储蓄。
BACKGROUND: In recent years, different urinary markers such as the Bladder Epicheck® have been developed in an attempt to reduce the number of cystoscopies in the follow-up of non-muscle invasive bladder cancer (NMIBC).
OBJECTIVE: To provide a systematic
review of Bladder Epicheck® and its current clinical utility in the follow-up and detection of recurrence of NMIBC.
METHODS: Systematic
review based on a literature search of PubMed, Web of Science and Scopus databases until October 2023, according to PRISMA and Quadas-2 criteria. Sensitivity (Se), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV) of the marker were calculated. Diagnostic performance was evaluated by the area under the curve (AUC).
RESULTS: Fifteen studies were analyzed (n = 3761) including 86.7% prospective studies. Of the patient series, 53.2% had received previous intravesical instillations. The mean Se of the biomarker in the detection of recurrence varied according to tumor grade (87.9%-high grade/HG vs. 44.9%-low grade/LG, respectively). Their weighted mean Se and Sp were 71.6% and 84.5%, respectively. The mean recurrence rate was 29.1%. The weighted mean PPV and NPV were 56.4% and 92.8% (97.7% non-LG), respectively. The mean AUC was 85.63%.
CONCLUSIONS: Bladder Epicheck® is a useful urinary marker in the follow-up of NMIBC, with significantly high Se and NPV in the detection of recurrences, especially in cases of HG disease. Its use can reduce the number of cystoscopies required in the follow-up of NMIBC, improving the quality of life of patients and potentially increasing health economic savings.
