T1期高级别尿路上皮癌的治疗进展

膀胱癌是泌尿系统常见的肿瘤，其中90%以上的膀胱癌病理类型为尿路上皮癌，按照肿瘤浸润深度可分为非肌层浸润性尿路上皮癌(Non muscle invasive bladder cancer, NMIBC)和肌层浸润性尿路上皮癌。NMIBC主要是指肿瘤侵及固有层(T1)、粘膜层(Ta)和原位癌(Tis),其预后较好。其中Ta、T1期肿瘤占大多数，两者虽然都属于NMIBC,但生物学特性不同，由于固有层血管和淋巴管丰富，故T1期肿瘤较容易发生扩散和复发。本文将重点针对T1期高级别尿路上皮癌的各种治疗方式，包括手术治疗、介入治疗、药物化疗和免疫治疗等方面做一综述，特别探讨了如何利用手术治疗方式以及手术治疗联合化疗提高治疗效果，减少复发，提高生存时间。

Progress in the treatment of T1 high-grade urothelial carcinoma

Bladder cancer is a common tumor of the urinary system.More than 90% of bladder cancers are urothelial carcinoma.According to the depth of tumor invasion,it can be divided into non-muscle invasive urothelial carcinoma(NMIBC)and muscular invasive urothelial carcinoma.NMIBC has a good prognosis,which mainly refers to tumor invasion into lamina propria(T1),mucosal layer(Ta)and carcinoma in situ(Tis).Among them,Ta and T1 stage tumors account for the majority.Although both belong to NMIBC,their biological characteristics are different from each other.Because of the abundance of blood vessels and lymphatic vessels in lamina propria,T1 stage tumors are more prone to spread and recurrence.This article will focus on different treatment methods for T1 high-grade urothelial carcinoma,including surgical treatment,interventional therapy,drug chemotherapy,immunotherapy,etc.,and especially discusses how to use surgical treatment and surgical treatment combined with chemotherapy to improve the treatment effect,reduce recurrence and improve the survival time.