MedNexus
2022年 · 第135卷第07期
出版日期 2022-04-05电子版 ￥0.00元
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Review Article
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巨噬细胞在急性肾损伤向慢性肾病转变中的驱动作用Xiaoming Meng, Juan Jin, Hui Yao Lan
中华医学杂志英文版2022年 135卷 07期
DOI: 10.1097/CM9.0000000000002100
摘要
Acute kidney injury (AKI), characterized by acute renal dysfunction, is an increasingly common clinical problem and an important risk factor in the subsequent development of chronic kidney disease (CKD). Regardless of the initial insults, the progression of CKD after AKI involves multiple types of cells, including renal resident cells and immune cells such as macrophages. Recently, the involvements of macrophages in AKI-to-CKD transition have garnered significant attention. Furthermore, substantial progress has also been made in elucidating the pathophysiological functions of macrophages from the acute kidney to repair or fibrosis. In this review, we highlight current knowledge regarding the roles and mechanisms of macrophage activation and phenotypic polarization, and transdifferentiation in the development of AKI-to-CKD transition. In addition, the potential of macrophage-based therapy for preventing AKI-to-CKD transition is also discussed.
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丁型肝炎：进展与挑战Zhijiang Miao, Zhenrong Xie, Li Ren, Qiuwei Pan
中华医学杂志英文版2022年 135卷 07期
DOI: 10.1097/CM9.0000000000002011
摘要
Hepatitis D virus (HDV) infection causes the most severe form of viral hepatitis with rapid progression to cirrhosis, hepatic decompensation, and hepatocellular carcinoma. Although discovered > 40 years ago, little attention has been paid to this pathogen from both scientific and public communities. However, effectively combating hepatitis D requires advanced scientific knowledge and joint efforts from multi-stakeholders. In this review, we emphasized the recent advances in HDV virology, epidemiology, clinical feature, treatment, and prevention. We not only highlighted the remaining challenges but also the opportunities that can move the field forward.
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内镜袖状胃成形术：历史演变、生理学、结果和未来观点的叙述性综述Vitor Ottoboni Brunaldi, Manoel Galvao Neto
中华医学杂志英文版2022年 135卷 07期
DOI: 10.1097/CM9.0000000000002098
摘要
Since its first description in 2013, robust evidence supporting the efficacy and safety of the endoscopic sleeve gastroplasty (ESG) has been on the rise. A large case series and meta-analysis report supported results up to 24 months, while some other studies already described 5-year data. If associated with pharmacotherapy, the ESG may help one to achieve weight loss similar to that of surgical sleeve gastrectomy. Though the results of the ongoing randomized trials on ESG are awaited, currently available data support the clinical use of the ESG, especially for patients who are refusing or unfit for bariatric surgery.
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神经重症监护中的肺部并发症和呼吸管理：一项叙述性综述Junxian Wen, Jia Chen, Jianbo Chang, Junji Wei
中华医学杂志英文版2022年 135卷 07期
DOI: 10.1097/CM9.0000000000001930
摘要
Neurocritical care (NCC) is not only generally guided by principles of general intensive care, but also directed by specific goals and methods. This review summarizes the common pulmonary diseases and pathophysiology affecting NCC patients and the progress made in strategies of respiratory support in NCC. This review highlights the possible interactions and pathways that have been revealed between neurological injuries and respiratory diseases, including the catecholamine pathway, systemic inflammatory reactions, adrenergic hypersensitivity, and dopaminergic signaling. Pulmonary complications of neurocritical patients include pneumonia, neurological pulmonary edema, and respiratory distress. Specific aspects of respiratory management include prioritizing the protection of the brain, and the goal of respiratory management is to avoid inappropriate blood gas composition levels and intracranial hypertension. Compared with the traditional mode of protective mechanical ventilation with low tidal volume (Vt), high positive end-expiratory pressure (PEEP), and recruitment maneuvers, low PEEP might yield a potential benefit in closing and protecting the lung tissue. Multimodal neuromonitoring can ensure the safety of respiratory maneuvers in clinical and scientific practice. Future studies are required to develop guidelines for respiratory management in NCC.
Perspective
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产科抗磷脂综合征中的自然杀伤细胞Rongxiu Huo, Qianyu Guo, Junping Hu, Na Li, Hechao Liu, Zhaoliang Zhang, Liangyu Mi, Xinyue Peng, Liyun Zhang, Ke Xu
中华医学杂志英文版2022年 135卷 07期
DOI: 10.1097/CM9.0000000000001908
摘要
抗磷脂综合征(APS)是一种全身性自身免疫性疾病，其特征是由持续性抗磷脂抗体(APL)，即狼疮抗凝剂、抗心磷脂抗体或抗β 2糖蛋白I(抗β 2GPI)抗体引起的血栓形成或产科事件。[
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非编码RNA在白癜风中作用的最新进展Ting Zhou, Dong Li, Yunhua Deng
中华医学杂志英文版2022年 135卷 07期
DOI: 10.1097/CM9.0000000000001900
摘要
白癜风是一种普遍的毁容性皮肤病，其特征在于功能性黑素细胞的选择性缺失，影响全球人口的0.5%至1%。[
Viewpoint
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磁性再通治疗儿童食管狭窄的专家共识Shiqi Liu, Yi Lyu, Scientific Committee of the Third International Conference of Magnetic Surgery
中华医学杂志英文版2022年 135卷 07期
DOI: 10.1097/CM9.0000000000001957
摘要
术后狭窄是小儿先天性食管闭锁修补术后食管狭窄的最常见原因，[
Original Article
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抗H7N9禽流感病毒血凝素的广泛中和人单克隆抗体Jingxin Li, Li Zhang, Linlin Bao, Yuxiao Wang, Lin Qiu, Jialei Hu, Rong Tang, Huiyan Yu, Jun Shan, Yan Li 等
中华医学杂志英文版2022年 135卷 07期
DOI: 10.1097/CM9.0000000000002001
摘要
Background:
The new emerging avian influenza A H7N9 virus, causing severe human infection with a mortality rate of around 41%. This study aims to provide a novel treatment option for the prevention and control of H7N9.
Methods:
H7 hemagglutinin (HA)-specific B cells were isolated from peripheral blood plasma cells of the patients previously infected by H7N9 in Jiangsu Province, China. The human monoclonal antibodies (mAbs) were generated by amplification and cloning of these HA-specific B cells. First, all human mAbs were screened for binding activity by enzyme-linked immunosorbent assay. Then, those mAbs, exhibiting potent affinity to recognize H7 HAs were further evaluated by hemagglutination-inhibiting (HAI) and microneutralization in vitro assays. Finally, the lead mAb candidate was selected and tested against the lethal challenge of the H7N9 virus using murine models.
Results:
The mAb 6-137 was able to recognize a panel of H7 HAs with high affinity but not HA of other subtypes, including H1N1 and H3N2. The mAb 6-137 can efficiently inhibit the HA activity in the inactivated H7N9 virus and neutralize 100 tissue culture infectious dose 50 (TCID50) of H7N9 virus (influenza A/Nanjing/1/2013) in vitro, with neutralizing activity as low as 78 ng/mL. In addition, the mAb 6-137 protected the mice against the lethal challenge of H7N9 prophylactically and therapeutically.
Conclusion:
The mAb 6-137 could be an effective antibody as a prophylactic or therapeutic biological treatment for the H7N9 exposure or infection.
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乌司他丁对肺癌电视胸腔肺叶切除术后炎症反应影响的随机对照研究Won Jung Hwang, Min A. Joo, Jin Joo
中华医学杂志英文版2022年 135卷 07期
DOI: 10.1097/CM9.0000000000001937
摘要
Background:
The first-line treatment for lung cancer is surgical resection, and one-lung ventilation (OLV) is the most basic anesthetic management method in lung surgery. During OLV, inflammatory cytokines are released in response to the lung tissue damage and promote local and contralateral lung damage through the systemic circulation. We designed a randomized, prospective study to evaluate the effect of the urinary trypsin inhibitor (UTI) ulinastatin on the inflammatory response after video-assisted thoracic lobectomy in patients with lung cancer.
Methods:
Adult patients aged 19 to 70 years, who were scheduled for video-assisted thoracic lobectomy surgery to treat lung cancer between May 2020 and August 2020, were enrolled in this randomized, prospective study. UTI (300,000 units) mixed with 100 mL of normal saline in the ulinastatin group and 100 mL of normal saline in the control group was administered over 1 h after inducing anesthesia.
Results:
The baseline (T0) interferon-γ (IFN-γ)/interleukin-4 (IL-4) ratio was not different between the groups (6941.3 ± 2778.7 vs. 6954.3 ± 2752.4 pg/mL, respectively; P > 0.05). The IFN-γ/IL-4 ratio was significantly higher in ulinastatin group at 30 min after entering the recovery room than control group (20,148.2 ± 5054.3 vs. 6674.0 ± 2963.6, respectively; adjusted P < 0.017). Conclusion: Administering UTI attenuated the anti-inflammatory response, in terms of INF-γ expression and the IFN-γ/IL-4 ratio, after video-assisted thoracic surgery in lung cancer patients.
Trial registration:
Clinical Research Information Service of Korea National Institute of Health (CRIS), KCT0005533.
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我国高发区癌症家族史与食管癌及癌前病变的关系Jiachen Zhou, Kexin Sun, Shaoming Wang, Ru Chen, Minjuan Li, Jianhua Gu, Zhiyuan Fan, Guihua Zhuang, Wenqiang Wei
中华医学杂志英文版2022年 135卷 07期
DOI: 10.1097/CM9.0000000000001939
摘要
Background:
Family clustering of esophageal cancer (EC) has been found in high-risk areas of China. However, the relationships between cancer family history and esophageal cancer and precancerous lesions (ECPL) have not been comprehensively reported in recent years. This study aimed to provide evidence for identification of high-risk populations.
Methods:
This study was conducted in five high-risk areas in China from 2017 to 2019, based on the National Cohort of Esophageal Cancer. The permanent residents aged 40 to 69 years were examined by endoscopy, and pathological examination was performed for suspicious lesions. Information on demographic characteristics, environmental factors, and cancer family history was collected. Unconditional logistic regression was applied to evaluate odds ratios between family history related factors and ECPL.
Results:
Among 33,008 participants, 6143 (18.61%) reported positive family history of EC. The proportion of positive family history varied significantly among high-risk areas. After adjusting for risk factors, participants with a family history of positive cancer, gastric and esophageal cancer or EC had 1.49-fold (95% confidence interval [CI]: 1.36-1.62), 1.52-fold (95% CI: 1.38-1.67), or 1.66-fold (95% CI: 1.50-1.84) higher risks of ECPL, respectively. Participants with single or multiple first-degree relatives (FDR) of positive EC history had 1.65-fold (95% CI: 1.47-1.84) or 1.93-fold (95% CI: 1.46-2.54) higher risks of ECPL. Participants with FDRs who developed EC before 35, 45, and 50 years of age had 4.05-fold (95% CI: 1.30-12.65), 2.11-fold (95% CI: 1.37-3.25), and 1.91-fold (95% CI: 1.44-2.54) higher risks of ECPL, respectively.
Conclusions:
Participants with positive family history of EC had significantly higher risk of ECPL. This risk increased with the number of EC positive FDRs and EC family history of early onset. Distinctive genetic risk factors of the population in high-risk areas of China require further investigation.
Trial registration:
ChiCTR-EOC-17010553.
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雄激素完全阻断vs.单纯药物去势作为前列腺癌根治术后辅助雄激素剥夺治疗的回顾性队列研究Di Jin, Kun Jin, Bo Chen, Xianghong Zhou, Qiming Yuan, Zilong Zhang, Qiang Wei, Shi Qiu
中华医学杂志英文版2022年 135卷 07期
DOI: 10.1097/CM9.0000000000002021
摘要
Background:
Till date, the optimal treatment strategy for delivering adjuvant androgen deprivation therapy (ADT) in localized and locally advanced prostate cancer (PCa), as a lower stage in PCa progression compared with metastatic PCa, is still unclear. This study compares the efficacy of castration alone with complete androgen blockade (CAB) as adjuvant ADT in patients with localized and locally advanced PCa undergoing radical prostatectomy (RP).
Methods:
Patients diagnosed with PCa, without lymph node or distant metastasis, who received RP in West China Hospital between January 2009 and April 2019, were enrolled in this study. We performed survival, multivariable Cox proportional hazard regression, and subgroup analyses.
Results:
A total of 262 patients were enrolled, including 107 patients who received castration alone and 155 patients who received CAB. The survival analysis revealed that there was no significant difference between the two groups (hazard ratios [HR]=1.07, 95% confidence intervals [95% CI]=0.60-1.90, P=0.8195). Moreover, the multivariable Cox model provided similarly negative results before and after adjustment for potential covariant. Similarly, there was no significant difference in the clinical recurrence between the two groups in both non-adjusted and adjusted models. Furthermore, our subgroup analysis showed that CAB achieved better biochemical recurrence (BCR) outcomes than medical castration alone as adjuvant ADT for locally advanced PCa (P for interaction=0.0247, HR=0.37, 95% CI=0.14-1.00, P=0.0497).
Conclusion:
Combined androgen blockade achieved better BCR outcomes compared with medical castration alone as adjuvant ADT for locally advanced PCa without lymph node metastasis.
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与轻度瘢痕疙瘩进展为重度瘢痕疙瘩相关的危险因素Ruolin Liu, Haitao Xiao, Ru Wang, Wei Li, Ke Deng, Ying Cen, Xuewen Xu
中华医学杂志英文版2022年 135卷 07期
DOI: 10.1097/CM9.0000000000002093
摘要
Background:
Keloids are benign fibrous growths that are caused by excessive tissue build-up. Severe keloids exert more significant effects on patients’ quality of life than do mild keloids. We aimed to identify factors associated with the progression from mild keloids to severe keloids, as distinct from those associated with the formation of keloids.
Methods:
In this retrospective case-control study, 251 patients diagnosed with keloids at West China Hospital between November 2018 and April 2021 were grouped according to the severity of lesions (mild [n = 162] or severe [n = 89]). We collected their basic characteristics, living habits, incomes, comorbidities, and keloid characteristics from Electronic Medical Records in the hospital and the patients’ interviews. Conditional multivariable regression was performed to identify the independent risk factors for the progression of keloids.
Results:
Eighty-nine patients (35.5%) were classified as having severe keloids. We found the distribution of severe keloids varied with sex, age, excessive scrubbing of keloids, family income, the comorbidity of rheumatism, disease duration, characteristics of the location, location in sites of high-stretch tension, the severity and frequency of pain, the severity of pruritus, and infection. Multivariable analysis revealed significant associations between severe keloids and infection (odds ratio [OR], 3.55; P = 0.005), excessive scrubbing of keloids (OR, 8.65; P = 0.001), low or middle family income (OR, 13.44; P = 0.021), comorbidity of rheumatism (OR, 18.97; P = 0.021), multiple keloids located at multiple sites (OR, 3.18; P = 0.033), and disease duration >15 years (OR, 2.98; P = 0.046).
Conclusion:
Doctors should implement more active and thorough measures to minimize the progression of mild keloids in patients who have any of the following risk factors: infection, excessive scrubbing of keloids, low or middle family income, comorbidity of rheumatism, multiple keloids located at multiple sites, and disease duration >15 years.
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肝细胞生长因子保护肺内皮屏障抗氧化应激和线粒体依赖性凋亡Shanshan Meng, Feiping Xia, Jingyuan Xu, Xiwen Zhang, Ming Xue, Mingyuan Gu, Fengmei Guo, Yingzi Huang, Haibo Qiu, Yi Yang
中华医学杂志英文版2022年 135卷 07期
DOI: 10.1097/CM9.0000000000001916
摘要
Background:
Pulmonary microvascular endothelial cells (PMVECs) were not complex, and the endothelial barrier was destroyed in the pathogenesis progress of acute lung injury (ALI)/acute respiratory distress syndrome (ARDS). Previous studies have demonstrated that hepatocyte growth factor (HGF), which was secreted by bone marrow mesenchymal stem cells, could decrease endothelial apoptosis. We investigated whether mTOR/STAT3 signaling acted in HGF protective effects against oxidative stress and mitochondria-dependent apoptosis in lipopolysaccharide (LPS)-induced endothelial barrier dysfunction and ALI mice.
Methods:
In our current study, we introduced LPS-induced PMEVCs with HGF treatment. To investigate the effects of mammalian target of rapamycin (mTOR)/signal transducer and activator of transcription 3 (STAT3) pathway in endothelial oxidative stress and mitochondria-dependent apoptosis, mTOR inhibitor rapamycin and STAT3 inhibitor S3I-201 were, respectively, used to inhibit mTOR/STAT3 signaling. Moreover, lentivirus vector-mediated mTORC1 (Raptor) and mTORC2 (Rictor) gene knockdown modifications were introduced to evaluate mTORC1 and mTORC1 pathways. Calcium measurement, reactive oxygen species (ROS) production, mitochondrial membrane potential and protein, cell proliferation, apoptosis, and endothelial junction protein were detected to evaluate HGF effects. Moreover, we used the ALI mouse model to observe the mitochondria pathological changes with an electron microscope in vivo.
Results:
Our study demonstrated that HGF protected the endothelium via the suppression of ROS production and intracellular calcium uptake, which lead to increased mitochondrial membrane potential (JC-1 and mitochondria tracker green detection) and specific proteins (complex I), raised anti-apoptosis Messenger Ribonucleic Acid level (B-cell lymphoma 2 and Bcl-xL), and increased endothelial junction proteins (VE-cadherin and occludin). Reversely, mTOR inhibitor rapamycin and STAT3 inhibitor S3I-201 could raise oxidative stress and mitochondria-dependent apoptosis even with HGF treatment in LPS-induced endothelial cells. Similarly, mTORC1 as well as mTORC2 have the same protective effects in mitochondria damage and apoptosis. In in vivo experiments of ALI mouse, HGF also increased mitochondria structural integrity via the mTOR/STAT3 pathway.
Conclusion:
In all, these reveal that mTOR/STAT3 signaling mediates the HGF suppression effects to oxidative level, mitochondria-dependent apoptosis, and endothelial junction protein in ARDS, contributing to the pulmonary endothelial survival and barrier integrity.
Clinical Observation
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人表皮生长因子受体2基因检测的变化（Her-2）状态Her-2荧光的原地杂交试验Ying Xu, Changjun Wang, Yali Xu, Bo Pan, Qiang Sun
中华医学杂志英文版2022年 135卷 07期
DOI: 10.1097/CM9.0000000000001733
摘要
乳腺癌（BC）是常见诊断的恶性肿瘤之一，在2020年取代肺癌成为全球最主要的诊断癌症。[
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内镜治疗气管造口术后气管狭窄的疗效和结果：来自中国介入中心的回顾性研究Feng Chen, Jie Zhang, Xiaojian Qiu, Ting Wang, Yinghua Pei
中华医学杂志英文版2022年 135卷 07期
DOI: 10.1097/CM9.0000000000001634
摘要
插管后或气管造口术后气管狭窄是获得性良性气道狭窄的最常见原因。由于大容量低压袖带的广泛使用以及对监测袖带压力的必要性的认识，插管后气管狭窄（PITS）的发生率正在降低。然而，气管切开术后气管狭窄（PTTS）的发生率仍然很高，严重影响患者的生活质量。PTTS常由气道软骨损伤、局部缺血性坏死、气管切开部位感染、远端气管切开管与气管壁摩擦等引起。先前的研究报道，手术切除和重建是PTTS治疗的最佳选择；然而，内镜技术的出现使其成为外科治疗的合适替代方案，尤其是对于气管节段长期破坏或有严重合并症的患者。[
Correspondence
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混合性侵袭性肺毛霉菌和曲霉属感染1例并文献复习Peikun Teng, Xiudi Han, Shuli Zhang, Dong Wei, Yi Wang, Deshun Liu, Xuedong Liu
中华医学杂志英文版2022年 135卷 07期
DOI: 10.1097/CM9.0000000000001839
摘要
致编辑：侵袭性肺毛霉菌病（IPM）是一种罕见但危及生命的机会性真菌病，死亡率高达40%~80%。[
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MicroRNA-29b抑制TGF-β诱导的自发性高血压大鼠肾间质上皮-间质转化Yihao Wu, Zhi Zhang, Zhe Chen, Chen Fu, Lu Huang, Jiabing Wang, Jian Li, Andrew Barszczyk, Deye Yang
中华医学杂志英文版2022年 135卷 07期
DOI: 10.1097/CM9.0000000000001922
摘要
致编辑：高血压是众所周知的心血管疾病，其中肾脏由于其在液体、电解质平衡和血压调节中的作用而成为重要的靶点。[
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妊娠急性脂肪肝的Swansea标准评分Jianbo Tan, Fei Hou, Haofeng Xiong, Lin Pu, Pan Xiang, Chuansheng Li
中华医学杂志英文版2022年 135卷 07期
DOI: 10.1097/CM9.0000000000001821
摘要
致编辑：妊娠急性脂肪肝（AFLP）是一种罕见但潜在致命的妊娠特有疾病，通常发生在妊娠晚期，是危重患者孕产妇死亡的主要原因之一。[
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移植肾急性大叶性肾病的临床特点Yuchen Wang, Yu He, Yanna Liu, Ziyan Yan, Wenli Zeng, Wenfeng Deng, Yiling Fang, Genxia Wei, Jian Xu, Yun Miao
中华医学杂志英文版2022年 135卷 07期
DOI: 10.1097/CM9.0000000000001997
摘要
致编辑：急性大叶性肾病(ALN)，也称为急性局灶性细菌性肾炎，是一种严重形式的上尿路感染(UTI)，其特征在于肾脏中存在炎性肿块病变而没有脓肿形成。它被认为是急性肾盂肾炎和肾脓肿之间的中点。[
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来氟米特治疗成人类固醇依赖性微小病变或原发性局灶节段性肾小球硬化患者Chenyang Zhao, Zhao Cui, Yimiao Zhang, Fang Wang, Xin Wang, Xuyang Cheng, Liqiang Meng, Gang Liu, Minghui Zhao
中华医学杂志英文版2022年 135卷 07期
DOI: 10.1097/CM9.0000000000001855
摘要
致编辑：微小变化病（MCD）和局灶节段性肾小球硬化（FSGS）是成人和儿童肾病综合征的常见组织学亚型。[
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生物膜形成和侵袭能力有助于CC17血清型III B组链球菌毒力Lijun Wang, Zhi Tao, Binghuai Lu
中华医学杂志英文版2022年 135卷 07期
DOI: 10.1097/CM9.0000000000001861
摘要
致编辑：B组链球菌（GBS）定植于7-30%孕妇的阴道和直肠，并导致母婴侵袭性感染。迄今为止，临床GBS菌株的发病机制仍然难以捉摸。
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甘草—马尾藻提取物对Sprague-Dawley大鼠的亚急性毒性：生化、组织病理学和药代动力学研究Xinyue Jing, Xian Meng, Zhenhui Wu, Yongfang Ding, Yunru Peng, Mingqing Shen, Qing Wang
中华医学杂志英文版2022年 135卷 07期
DOI: 10.1097/CM9.0000000000001716
摘要
致编辑：东方药理学不可或缺的组成部分“十八种拮抗药物”中指出，马尾藻和甘草不宜同时服用。[
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东北地区464例大疱性类天疱疮患者的回顾性研究Qiang Wang, Ruiqun Qi, Jianping Li, Fengqiu Lin, Xianwei Han, Xiuyu Liang, Xiaodong Sun, Yue Feng, Kaibo Wang, Chunlin Jin 等
中华医学杂志英文版2022年 135卷 07期
DOI: 10.1097/CM9.0000000000001744
摘要
致编辑：大疱性类天疱疮（BP）是一种慢性自身免疫性水疱性疾病，其特征在于与干扰基底表皮角质形成细胞粘附的两种半桥粒蛋白（BP180和BP230）的自身抗体相关。BP的全球发病率为每年2.5至75例/百万。[
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光疗法治疗帕金森病的疗效和安全性Yanghong Li, Xiaoxia Zhou, Xinyin Wu, Beisha Tang
中华医学杂志英文版2022年 135卷 07期
DOI: 10.1097/CM9.0000000000001818
摘要
致编辑：帕金森病（PD）是第二种最常见的神经退行性疾病，与显著残疾和对生活质量（QoL）的负面影响相关，影响≥65岁人群的2%至3%。[
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膀胱癌中的人工智能：当前趋势和未来可能性Jun Ma, Deep K. Vaishnani, Rixu Lin, Jiayu Lyu, Bingyan Ni, Yang Zhang, Mengjun Hu, Guorong Chen
中华医学杂志英文版2022年 135卷 07期
DOI: 10.1097/CM9.0000000000001830
摘要
致编辑：膀胱癌是亚洲人群中最常见的泌尿系统恶性肿瘤。在中国，每年报告80,000例新病例，并且发病率每年都在增加。在这些病例中，75%是非肌层浸润性膀胱癌（NMIBC）。在肌层浸润性膀胱癌（MIBC）和NMIBC患者中，由于肿瘤进展的风险较高，根治性膀胱切除术被认为是主要的治疗方法。此外，膀胱镜检查和传统的经尿道电切术是膀胱癌诊断和分期的主要方法。然而，这些方法相对危险，因为它们的并发症和高围手术期死亡率。[
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