Effective ways to diagnose bladder cancer at early stage

Bladder cancer is a disease that we all worry about. People are under great pressure in life nowadays. In order to complete their work, sometimes they don’t go to the toilet for a long time, so many people suffer from the disease. Here we will introduce to you some effective ways to diagnose bladder cancer in the early stage.

Adults, especially those over 40 years old, who have painless hematuria, especially terminal hematuria, should think of urinary tract tumors, and the possibility of bladder tumors should be considered first. During the physical examination, pay attention to whether there is tenderness in the bladder area. During the rectal digital examination, pay attention to whether there is a lump in the bladder area and the activity. When the bladder tumor has not invaded the muscle layer, this examination is often negative. If a lump can be felt, it indicates that the cancer has infiltrated deeply and the lesion is in the late stage.

The following tests may be helpful in screening or confirming the diagnosis.

1. Patients with long-term microscopic hematuria in urine routine and phase contrast microscopy analysis indicating that the hematuria comes from the lower urinary tract should be alert to the occurrence of bladder tumors. Since hematuria caused by bladder tumors can be intermittent, 1 to 2 normal urine routine tests cannot rule out bladder cancer.

2. Urine exfoliated cell examination Urine cytology (UC) examination is an important means of detecting bladder cancer, especially for detecting high-grade tumors (including Cis). Increased cell volume, increased nuclear-cytoplasm ratio, nuclear polymorphism, nuclear deep staining and irregularity, and nucleolar protrusions are characteristic findings of high-grade bladder cancer. In order to prevent missed diagnosis of autolysis of tumor cells and increase the positive rate, urine is generally examined for 3 consecutive days, and urine specimens should be sent for examination in time after being collected. Urine specimens can be obtained from patients' self-extracted urine or bladder washing fluid. Most data show that the positive rate of self-extracted urine is 20% lower than that of bladder washing fluid, but the former is non-invasive and easy to obtain; the latter is invasive, but more tumor cells can be obtained, and the cells are also better preserved. The sensitivity of urine cytology for high-grade tumors is 60% to 90%, and the specificity is 90% to 100%. The sensitivity for low-grade tumors is only 30% to 60%, but the specificity is still above 85%. In general, the sensitivity of urine cytology increases with the grade and clinical stage of bladder cancer cells. Urine cytology is particularly important for diagnosing Cis, because Cis cancer cells have poor adhesion and are easy to fall off, making them difficult to detect by cystoscopy.

3. Tumor marker detection An ideal tumor marker detection should have good sensitivity and specificity, and the detection should be fast, easy to operate, and inexpensive. Although there are many literature reports that tumor markers in urine can be used to diagnose bladder cancer, there is currently insufficient clinical data to prove that these markers can replace cystoscopy in the diagnosis of bladder tumors. Nevertheless, they still have broad clinical application space due to their advantages such as rapidity, simplicity, non-invasiveness, and high sensitivity.

4. Cystoscopy Cystoscopy is of decisive significance for diagnosis. Cystoscopy should include the entire urethra and bladder. When examining the bladder, it should be filled slowly while observing. For protrusions on the bladder wall, it is necessary to distinguish between true lesions and mucosal folds. Overfilling should be avoided to avoid covering up small lesions, such as Cis. In most cases, the location, size, number of tumor growth, and its relationship with the ureteral opening and the internal urethral opening can be directly seen. Samples can be taken near and far from the tumor to understand whether there is epithelial variation or carcinoma in situ. This is a very important step in determining treatment plans and prognosis. When taking a biopsy, it is important to take samples from the root and top of the tumor at the same time and send them separately for pathological examination, because the malignancy of the top tissue is generally higher than that of the root. If no tumor is found, the bladder is repeatedly flushed, and the flushing fluid is collected together with the self-lysed urine before the examination for cytological examination.

5. Ultrasound examination Ultrasound examination can clearly show the location, number, size, shape and base width of the tumor when the bladder is moderately filled. It can distinguish bladder tumors larger than 0.5 cm and detect whether the upper urinary tract is dilated by hydrops. It is currently the most convenient, economical and high detection rate diagnostic method for bladder cancer. Ultrasound examination has three routes: transabdominal (TABUS), transrectal and transurethral. Among them, TABUS is the simplest and most convenient, with rapid examination and no pain for patients. It can be repeated several times in a short period of time. It is the preferred method for preoperative diagnosis and staging of bladder cancer and postoperative review. However, TRUS and TUUS can more clearly show the location and degree of infiltration of bladder cancer and can stage bladder cancer more accurately.

6. X-ray KUB plain film cannot be used to diagnose bladder tumors, but it can be used to understand whether there are concomitant urinary stones. Intravenous pyelography can understand whether there are tumors of the upper urinary tract at the same time. Larger bladder tumors can show filling defects in the bladder.

The above are the effective ways to diagnose bladder cancer in its early stages that we all want to know. Bladder cancer is what we all should pay the most attention to. In order to make our lives better, we must have an in-depth understanding of the diseases around us, which will give us a healthy body.