Urine cytology in monitoring recurrence in urothelial carcinoma after radical cystectomy and urinary diversion
Urine cytology in monitoring recurrence in urothelial carcinoma after radical cystectomy and urinary diversion
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DOI：
10.1002/cncy.21650
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发表时间：
2016-04-01
影响因子：
3.4
通讯作者：
Wojcik, Eva M.
中科院分区：
文献类型：
--
作者：
Chen, Haiyan;Liu, Lin;Wojcik, Eva M.
研究背景尿路上皮癌（UCa）根治性膀胱切除术和尿流改道术（RC-UD）后，上尿路和尿道复发的发生率为2%~ 17%。本研究的目的是确定的性能，尿细胞学（UCy）在诊断复发的残余尿路上皮（RRU）后，RC-UD。METHODS作者回顾性地确定了所有患者谁接受RC-UD的UCa在研究机构从2002年1月至2014年4月，并收集所有可用的后续UCy和活检的数据。细胞学分类为不满意、阴性、可疑、恶性肿瘤阳性或非典型尿路上皮细胞（AUC）。作者计算了可疑或阳性UCy诊断组织学证实的RRU.C.TSS222例患者谁经历了RC-UD膀胱UCa在研究期间，111人至少有一个后续UCy在研究机构进行，共477 UCy样本的敏感性，特异性，阳性预测值和阴性预测值。在平均40.8个月（范围：3-155个月）的随访期间，RRU率为9.9%（11/111例患者）。在111例患者中的12例中观察到阳性/可疑UCy结果，其中9例患有RRU。在29例患者的8.6%的样本（477份样本中的41份）中进行了AUC诊断。UCy对RRU的敏感性、特异性、阳性预测值和阴性预测值分别为82%、97%、75%和98%。AUC诊断的28例患者中有6例（21.4%）最终诊断为RRU.CONCLUSIONSIn当前系列，UCy表现出良好的敏感性和高特异性，用于检测RC-UD后UCa的疾病复发。Cancer Cytopathol 2016;124：273-8. (c)2015年美国癌症协会。在目前的研究中，111名患者接受根治性膀胱癌和尿流改道治疗，其中11人在平均40.8个月的随访间隔期间发生疾病复发，尿细胞学表现出高灵敏度，特异性，阳性和阴性预测值（分别为82%、97%、75%和98%）用于检测尿路上皮癌复发。28例诊断为非典型尿路上皮细胞的患者中有6例（21.4%）最终发现尿路上皮癌复发。
BACKGROUNDAfter radical cystectomy and urinary diversion (RC-UD), upper urinary tract and urethral recurrences of urothelial carcinoma (UCa) are reported to occur in 2% to 17% of patients. The objective of the current study was to determine the performance of urinary cytology (UCy) in the diagnosis of recurrences in the remnant urothelium (RRU) after RC-UD.METHODSThe authors retrospectively identified all patients who underwent RC-UD for UCa at the study institution from January 2002 to April 2014, and collected data from all available follow-up UCy and biopsies. Cytologies were classified as unsatisfactory, negative, suspicious, positive for malignancy, or atypical urothelial cells (AUC). The authors calculated the sensitivity, specificity, positive predictive value, and negative predictive value of suspicious or positive UCy for the diagnosis of histologically confirmed RRU.RESULTSOf the 222 patients who underwent RC-UD for UCa of the urinary bladder during the study period, 111 had at least 1 follow-up UCy performed at the study institution, for a total of 477 UCy samples. During a mean follow-up interval of 40.8 months (range, 3-155 months), the RRU rate was 9.9% (11 of 111 patients). Positive/suspicious UCy results were noted in 12 of 111 patients, 9 of whom had RRU. A diagnosis of AUC was made in 8.6% of samples from 29 patients (41 of 477 samples). The sensitivity, specificity, positive predictive value, and negative predictive value of UCy for RRU were 82%, 97%, 75%, and 98%, respectively. Six of the 28 patients with diagnoses of AUC (21.4%) were eventually diagnosed with RRU.CONCLUSIONSIn the current series, UCy demonstrated good sensitivity and high specificity for the detection of disease recurrence of UCa after RC-UD. Cancer Cytopathol 2016;124:273-8. (c) 2015 American Cancer Society.In the current study of 111 patients treated with radical cystectomy and urinary diversion, 11 of whom developed disease recurrence during a mean follow-up interval of 40.8 months, urine cytology demonstrated high sensitivity, specificity, and positive and negative predictive values (82%, 97%, 75%, and 98%, respectively) for the detection of urothelial carcinoma recurrence. Six of 28 patients with a diagnosis of atypical urothelial cells (21.4%) were eventually found to have recurrences of urothelial carcinoma.