使用Likert scale預測非肌肉侵犯性膀胱癌之外在效度-高雄長庚經驗

蔡佳宏、江博暉、莊燿吉、陳彥達、王弘仁、李維菁、康智雄

、李偉嘉、陳建旭、羅浩倫、沈元琦、劉惠瑛、鄭元佐

高雄長庚紀念醫院 泌尿科

External validation of Likert scale for predicting
non-muscle invasive bladder cancer, KCGMH experience

Tsai-Chia Hung, Po-Hui Chiang, Yao-Chi Chuang, Yen-Ta Chen, Hung-Jen Wang, Wei-Ching Lee, Chih-Hsiung Kang, Wei-Chia Lee, Chien-Hsu Chen, Hao-Lun Luo, Yuan-Chi Shen, Hui-Ying Liu,  Yuan-Tso Cheng

Department of Urology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan

Purpose:

Bladder cancer is a heterogeneous disease that can be limited to a relatively indolent papillary tumor with low potential for progression beyond this stage to muscle-invasive disease prone to distant metastasis. Most bladder cancer initially found by cystoscopy. Recent study found a morphologic classification, The Likert scale, can be a good predictor for differentiating high risk muscle invasive bladder cancer (MIBC) from it’s counterpart, the non-muscle invasive bladder cancer (NMIBC). To validate the usefulness of Likert scale, we conduct a retrospective study in patient with newly diagnosed bladder cancer.

Materials and Methods:

31 patients with new diagnosed bladder cancer were included from January 2020 to December 2020 in KCGMH. The Likert scale was used during the first flexible cystoscopic examination. All patient received confirmative transurethral resection of bladder (TURBT), which requires adequate muscle layer to identified muscle invasion. Data of 35 patients with newly diagnosed bladder cancer were collected in KCGMH, 4 patient were excluded due to inadequate muscle layer for confirmed stage.

Results:

A total of 16 patients were Likert score 1-2 (group 1) and 15 patients were Likert 3-5 (group 2). As for patients in group 1, final pathologic report showed 14 NMIBC and 2 MIBC. In group 2, after TURBT, 11 patients were MIBC and four patient were NMIBC. For patient with tumor characteristic of group 1 Likert scale, the positive predictive value (PPV) and negative predictive value (NPV) of NMIBC is 87.5% and 73.3%, respectively. For patient with tumor characteristic of group 2 Likert scale, the PPV and NPV of MIBC is 73.3% and 87.5%, respectively.

Conclusions: