- 标题
- 摘要
- 关键词
- 实验方案
- 产品
-
Fluorescence in situ hybridization in 1?mL of selective urine for the detection of upper tract urothelial carcinoma: a feasibility study
摘要： Kidney-sparing surgery of upper tract urothelial carcinoma (UTUC) requires a stringent follow-up with frequent ureteroscopies. Triage testing could reduce the number of follow-up ureteroscopies and hence minimize the invasiveness of follow-up. The use of urine-based markers for triage seems appealing but should be feasible with selective urine from outpatient cystoscopy to maximize the reduction of invasiveness. In this study, the feasibility of UroVysion? fluorescence in?situ hybridization (FISH) for the detection of UTUC in 1?mL of selective urine is investigated. Ten consecutive patients with biopsy-proven UTUC and five patients with negative diagnostic ureteroscopy findings were included in this case-control study. During ureteroscopy, 1?mL of selective urine was collected passively with a ureteral splint for Urovysion? FISH. The FISH rater was blinded to any clinical information. The results of FISH were compared to the findings of concomitantly collected selective urine cytology and the patients’ UTUC status. FISH was feasible in all samples with a sensitivity of 90% and a specificity of 80% for UTUC. In comparison, selective cytology resulted in a diagnostic yield of 87% with a sensitivity of 80% and a specificity of 67%. In conclusion,?UTUC detection is feasible with FISH in 1?mL of passively collected selective urine. Thus from a technical point of view, FISH could be used as an outpatient triage test to decide if follow-up ureteroscopy is necessary after kidney-sparing surgery of UTUC. Evaluation of the diagnostic accuracy of FISH for the suggested pathway deserves further attention.
关键词： Ureteroscopy,Urothelial carcinoma,Cystoscopy,Fluorescence in?situ hybridization,Urine cytology,Upper tract urothelial carcinoma
更新于2025-09-23 15:21:21
-
Combination of holmium and thulium laser ablation in upper tract urothelial carcinoma
摘要： Thanks to the latest technological and technical advances in endourology, the management of upper tract urothelial cancer (UTUC) has changed over the last years, with expanding indications for a conservative approach. The endourological management has been described by means of flexible ureteroscopes and of holmium:YAG fibre lasers. A systematic review showed that oncologic outcomes at 5 and 10 years of follow-up were similar by comparing cohorts of low-risk UTUC patients undertaking either nephroureterectomy or endourological ablation. Accordingly, since 2018 the European Association of Urology Guidelines on UTUC have recommended the elective conservative management of UTUC in selected patients with low-risk lesions, i.e., those 2 cm in size, solitary, low-grade, non-muscle-infiltrative and without upper urinary tract dilatation at CT scan. More recently, the use of thulium laser (TL) has been described in the context of UTUC: as far as it concerns the technical features, TL consists of a diode-pumped laser that provides a continuous wave and a lower tissue penetration, which allow for a more precise vaporization, excellent coagulation, and a lower risk of injury to normal tissue, making it the ideal laser to deal with soft tissue disease. In 2011, Defidio et al., in a series of 59 cases of UTUC, demonstrated that the thulium laser ablation was non-inferior to holmium:YAG laser ablation in terms of oncological outcomes. More recently, Musi et al. reported the outcomes of the largest published cohort of UTUC patients (n = 42) undertaking thulium laser vaporization: the authors showed oncological outcomes comparable to those available in literature, with a recurrence-free survival of 81% at a median of 44 months of follow-up, and a very low rate of complications.
关键词： UTUC,thulium laser,endourology,holmium laser,upper tract urothelial carcinoma
更新于2025-09-23 15:19:57