Ureterorenoscopic biopsy and urinary cytology according to the 2004 WHO classification underestimate tumor grading in upper urinary tract urothelial carcinoma
Ureterorenoscopic biopsy and urinary cytology according to the 2004 WHO classification underestimate tumor grading in upper urinary tract urothelial carcinoma
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DOI：
10.1016/j.urolonc.2011.12.021
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发表时间：
2013-10-01
影响因子：
2.7
通讯作者：
Tritschler, Stefan
中科院分区：
文献类型：
--
作者：
Straub, Julia;Strittmatter, Frank;Tritschler, Stefan
目的：目的：探讨上尿路上皮癌（UUT-UC）患者上尿路细胞学及输尿管镜活检对肿瘤分级的准确性。方法：回顾性分析77例肾输尿管切除标本的病理报告，并与术前细胞学及输尿管镜活检结果进行比较。结果：细胞学和活检诊断UUT-UC的总体敏感性分别为64%和74%。细胞学和活检预测高级别癌症的准确性分别为53%和58%。细胞学和活检相结合，可以提高敏感性（84%）和准确性（68%），但即使是这种组合，15%的高级别肿瘤被误解为低级别cancer.Conclusion：我们的研究结果显示，只有有限的准确性术前细胞学和输尿管肾镜进行活检的UUT-UC的正确肿瘤分级的预测。因此，我们建议在决定对UUT-UC患者进行明确的手术治疗之前，使用额外的诊断程序。(C)2013 Elsevier Inc. All rights reserved.
Objectives: To determine accuracy of upper tract cytology and ureteroscopic biopsy according to the 2004 World Health Organization (WHO) classification in predicting the correct tumor grade in patients with urothelial cancer of the upper urinary tract (UUT-UC).Methods: Pathology reports of 77 nephroureterectomy specimens were retrospectively analyzed for tumor grade and compared with preoperatively gained cytology and ureteroscopic biopsy results. For analysis, the 2004 WHO classification was used.Results: Overall sensitivity of cytology and biopsy in diagnosis of UUT-UC was 64% and 74%, respectively. Accuracy of cytology and biopsy in predicting high grade cancer was 53% and 58%, respectively. Combination of cytology and biopsy could improve sensitivity (84%) and accuracy (68%), but even for this combination, 15% of high grade tumors were misinterpreted as low grade cancer.Conclusion: Our results show only limited accuracy for preoperative cytology and ureterorenoscopically performed biopsies in the prediction of the correct tumor grading of an UUT-UC. Therefore, we suggest the use of additional diagnostic procedures before the decision for definitive surgical treatment in patients with UUT-UC is made. (C) 2013 Elsevier Inc. All rights reserved.