血尿是泌尿道癌症的主要症状，需要进一步研究。为了确定肾膀胱超声 (RBUS) 与血尿癌症风险评分 (HCRS) 的能力，以告知血尿患者使用膀胱镜检查。开发队列由 1984 名患者组成来自 40 家英国医院（DETECT 1；ClinicalTrials.gov：NCT02676180）接受 RBUS 治疗的血尿患者。一个独立的验证队列由 500 名因怀疑患有膀胱癌而转诊至二级护理的连续患者组成。评估了 HCRS 和 RBUS 的敏感性和真阴性。总共有 134 名 (7%) 和 36 名 (8%) 患者处于开发和治疗阶段。验证队列分别被诊断为尿路癌。 HCRS 的验证实现了良好的区分度，验证队列中受试者工作特征曲线下面积为 0.727（95% 置信区间 0.648-0.800），癌症识别灵敏度为 95%。在开发队列中，利用 HCRS 与 RBUS 相结合得出的 4.500 的截止值，680 名 (34%) 患者将免于接受膀胱镜检查，但代价是错过了 G1 Ta 膀胱癌和尿路癌患者，而 117 名 (25 %) 患者本可以避免接受膀胱镜检查，但代价是漏掉一名 G1 Ta 膀胱癌患者，验证队列中癌症识别的敏感性为 97%。带有 RBUS 的 HCRS 在识别哪些患者受益方面提供了良好的辨别能力膀胱镜检查，使选定的患者群体免受侵入性手术的影响。肾膀胱超声的血尿癌症风险评分可以对血尿患者进行分类，这些患者将受益于膀胱的目视检查（膀胱镜检查）。这使得 25% 的患者安全地省略了膀胱镜检查，这是一种侵入性手术，将节省医疗费用。版权所有 © 2024 欧洲泌尿外科协会。由 Elsevier B.V. 出版。保留所有权利。

Hematuria is a cardinal symptom of urinary tract cancer and would require further investigations.To determine the ability of renal bladder ultrasound (RBUS) with the Hematuria Cancer Risk Score (HCRS) to inform cystoscopy use in patients with hematuria.The development cohort comprised 1984 patients with hematuria from 40 UK hospitals (DETECT 1; ClinicalTrials.gov: NCT02676180) who received RBUS. An independent validation cohort comprised 500 consecutive patients referred to secondary care for a suspicion of bladder cancer.Sensitivity and true negative of the HCRS and RBUS were assessed.A total of 134 (7%) and 36 (8%) patients in the development and validation cohorts, respectively, had a diagnosis of urinary tract cancer. Validation of the HCRS achieves good discrimination with an area under the receiver operating characteristic curve of 0.727 (95% confidence interval 0.648-0.800) in the validation cohort with sensitivity of 95% for the identification of cancer. Utilizing the cutoff of 4.500 derived from the HCRS in combination with RBUS in the development cohort, 680 (34%) patients would have been spared cystoscopy at the cost of missing a G1 Ta bladder cancer and a urinary tract cancer patient, while 117 (25%) patients would have avoided cystoscopy at the cost of missing a single patient of G1 Ta bladder cancer with sensitivity for the identification of cancer of 97% in the validation cohort.The HCRS with RBUS offers good discriminatory ability in identifying patients who would benefit from cystoscopy, sparing selected patient cohorts from an invasive procedure.The hematuria cancer risk score with renal bladder ultrasound allows for the triage of patients with hematuria who would benefit from visual examination of the bladder (cystoscopy). This resulted in 25% of patients safely omitting cystoscopy, which is an invasive procedure, and would lead to health care cost savings.Copyright © 2024 European Association of Urology. Published by Elsevier B.V. All rights reserved.