690 URINARY MARKERS FOR THE DETECTION OF UPPER URINARY TRACT UROTHELIAL CARCINOMA u THE VALUE OF INVASIVE URINE-SAMPLING

You have accessJournal of UrologyUrothelial Cancer: upper Tract Tumors (I)1 Apr 2013690 URINARY MARKERS FOR THE DETECTION OF UPPER URINARY TRACT UROTHELIAL CARCINOMA û THE VALUE OF INVASIVE URINE-SAMPLING Tilman Todenhöfer, Jörg Hennenlotter, Michael Esser, Stefan Aufderklamm, Sarah Mohrhardt, Georgios Gakis, Ursula Kühs, Arnulf Stenzl, and Christian Schwentner Tilman TodenhöferTilman Todenhöfer Tübingen, Germany , Jörg HennenlotterJörg Hennenlotter Tübingen, Germany , Michael EsserMichael Esser Tübingen, Germany , Stefan AufderklammStefan Aufderklamm Tübingen, Germany , Sarah MohrhardtSarah Mohrhardt Tübingen, Germany , Georgios GakisGeorgios Gakis Tübingen, Germany , Ursula KühsUrsula Kühs Tübingen, Germany , Arnulf StenzlArnulf Stenzl Tübingen, Germany , and Christian SchwentnerChristian Schwentner Tübingen, Germany View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.246AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Previous studies have shown a good performance of urine fluorescence in situ hybridization (FISH) for the detection of upper urinary tract (UUT) urothelial carcinoma (UUT-UC). Although not considered a standard procedure, several centers perform selective sampling of UUT urine with subsequent cytology and FISH. The additional value of this sampling method is widely unknown. The present study compares the performance of FISH and cytology in voided vs. UUT-derived urine samples in patients with suspect of UUT-UC. METHODS 561 patients with suspect of UUT-UC receiving a complete workup (including imaging and ureterenoscopy (URS)) were included. 305 were analyzed by voided urine and 256 by UUT-derived samples. Cytology and FISH were performed as urine markers. Sensitivities, specificities, negative (NPVs) and positive predictive values (PPVs) were calculated by contingency analysis. RESULTS 76 (13.5%) patients had UUT-UC (27 in the VU group and 49 in the UUT-derived urine group). For VU-samples, sensitivities, specificities, NPVs and PPVs of cytology were 59.3%, 84.0%, 95.3%, 27.6% versus 79.2%, 63.1%, 92.8% and 33.6% in UUT-derived samples. For FISH perfomed in VU samples, sensitivities, specificities, NPVs and PPVs were 52.9%, 87.6%, 95.8%, 25.7% versus 78.6%, 47.1%, 94.1% and 16.9% in UUT-derived samples. CONCLUSIONS FISH and cytology showed a higher sensitivitiy in UUT-derived samples compared to VU. However, performing UUT-sampling is associated with a considerable decrease in specificity of these tests. The invasive method of UUT-sampling might therefore lead to an increased number of unnecessary diagnostic procedures. Due to a relatively high number of FISH and CYT negative tumors in the upper urinary tract, urine markers alone cannot replace endoscopic workup. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e283 Peer Review Report Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Tilman Todenhöfer Tübingen, Germany More articles by this author Jörg Hennenlotter Tübingen, Germany More articles by this author Michael Esser Tübingen, Germany More articles by this author Stefan Aufderklamm Tübingen, Germany More articles by this author Sarah Mohrhardt Tübingen, Germany More articles by this author Georgios Gakis Tübingen, Germany More articles by this author Ursula Kühs Tübingen, Germany More articles by this author Arnulf Stenzl Tübingen, Germany More articles by this author Christian Schwentner Tübingen, Germany More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...