文章：

药物性强制利尿尿液细胞学在上尿路尿路上皮癌诊断与随访中的诊断价值

Diagnostic Value of Urine Cytology in Pharmacologically Forced Diuresis for Upper Tract Urothelial Carcinoma Diagnosis and Follow-Up

原文发布日期：12 February 2024

DOI: 10.3390/cancers16040758

类型: Article

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英文摘要：

We performed a urine cytology analysis of a pharmacologically induced diuresis for the diagnosis of upper tract urothelial carcinoma. To evaluate the diagnostic value of cytology of pharmacologically forced diuresis, an initial cohort of 77 consecutive patients with primary upper tract urothelial carcinoma treated via radical surgery was enrolled. To evaluate pharmacologically forced diuresis cytology as a follow-up procedure, a second cohort of 1250 patients who underwent a radical cystectomy for bladder cancer was selected. In the first cohort, the sensitivity of cytology of pharmacologically forced diuresis in patients with invasive, high-grade, low-grade, and concomitant carcinoma in situ was 8%, 9%, 0%, and 14%, respectively. In the second cohort, cytology of pharmacologically forced diuresis was positive in 30/689 (4.3%) patients, in whom upper urinary tract recurrence was present in 21/30 (70%) of cases, and urethral recurrence was present in 8/30 (26%) of cases. As a follow-up tool, cytology of pharmacologically forced diuresis showed a sensitivity, specificity, and positive and negative predictive values of 60%, 99%, 70%, and 98%, respectively. Overall, as a diagnostic tool, the sensitivity of cytology of pharmacologically forced diuresis is slightly better in patients with invasive upper tract urothelial carcinoma and concomitant carcinoma in situ. As a follow-up method, positive cytology of pharmacologically forced diuresis is strongly related to cancer recurrence and can reveal urethral recurrence. Cytology of pharmacologically forced diuresis might be useful in cases with contraindications for imaging or when achieving endoscopic access to the upper urinary tract is difficult.

摘要翻译： 

我们采用药物诱导利尿的尿液细胞学分析对上尿路尿路上皮癌进行诊断。为评估药物强制利尿细胞学的诊断价值，研究首先纳入了77例经根治性手术治疗的原发性上尿路尿路上皮癌连续病例作为初始队列。为评估药物强制利尿细胞学作为随访手段的价值，另选取1250例因膀胱癌接受根治性膀胱切除术的患者作为第二队列。在第一队列中，药物强制利尿细胞学对浸润性、高级别、低级别及伴发原位癌患者的敏感性分别为8%、9%、0%和14%。在第二队列中，689例患者中有30例（4.3%）药物强制利尿细胞学检测呈阳性，其中21/30例（70%）出现上尿路复发，8/30例（26%）出现尿道复发。作为随访工具，药物强制利尿细胞学的敏感性、特异性、阳性预测值和阴性预测值分别为60%、99%、70%和98%。总体而言，作为诊断工具，药物强制利尿细胞学对浸润性上尿路尿路上皮癌及伴发原位癌患者的敏感性略优。作为随访方法，药物强制利尿细胞学阳性结果与癌症复发密切相关，并能提示尿道复发。对于存在影像学检查禁忌或难以通过内镜进入上尿路的病例，药物强制利尿细胞学可能具有应用价值。

原文链接：

Diagnostic Value of Urine Cytology in Pharmacologically Forced Diuresis for Upper Tract Urothelial Carcinoma Diagnosis and Follow-Up