在英格兰的初级保健中定义复发性尿路感染和量化膀癌风险:全国性的病例控制研究
Sikhuphukile G Mahati1, Jianhua Wu2, Fiona M Walter1
1Centre for Cancer Screening, Prevention, and Early Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, UK.
The Lancet. Primary care
|March 16, 2026
概括
六个月内反复出现尿路感染 (UTI) 会显著增加膀癌的风险. 这一发现可以帮助完善早期诊断的指导方针,并改善频繁尿路感染患者的治疗结果.
科学领域:
- 在瘤学瘤学.
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 流行病学 流行病学
背景情况:
- 30-40%的膀癌患者在诊断之前出现了尿路感染症状.
- 目前针对复发性尿路感染的指导方针缺乏明确的定义,这可能会推迟诊断.
- 复发性尿路感染可能是膀癌的早期指标,需要更好地量化风险.
研究的目的:
- 定义和量化复发性尿路感染 (UTI) 与膀癌风险之间的关联.
- 调查尿路感染频率和时间对膀癌可能性的影响.
- 为确定患膀癌风险较高的个体提供临床指导方针.
主要方法:
- 在英格兰进行全国性的回顾性病例控制研究 (1998-2018).
- 来自国家癌症注册和分析服务 (NCRAS) 和临床实践研究数据链 (CPRD) 的数据.
- 根据年龄,性别和一般实践,匹配了17,157例膀癌病例与36,779例对照病例;分析了5年回顾间隔内的尿路感染频率.
主要成果:
- 在复发性尿路感染和膀癌风险之间观察到剂量反应关系,特别是在诊断后6个月内.
- 在0-6个月间隔的5个或更多的尿路感染显示了膀癌的最高几率比率 (13.05).
- 尿路感染和膀癌风险之间的关联随着尿路感染和癌症诊断之间的间隔较长而减少.
结论:
- 复发性尿路感染,特别是在6个月内,是膀癌风险的重要指标.
- 这些发现支持完善调查复发性尿路感染的指导方针,以改善早期膀癌检测.
- 在患有频繁尿路感染的患者中,需要对膀癌进行进一步的研究.
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