Lodde M, Mian C, Wiener H, Haitel A, Pycha A, Marberger M
Department of Urology, University of Vienna, Vienna, Austria.
Urology. 2001 Sep;58(3):362-6. doi: 10.1016/s0090-4295(01)01182-7.
To assess the clinical performance of ImmunoCyt in the detection of upper urinary tract transitional cell carcinoma (UT-TCC). This newly developed immunocytochemical test detects three cellular markers specific for TCC.
Thirty-seven patients with symptoms and/or findings on imaging suggestive of UT tumors were prospectively evaluated. All patients underwent a standard cytologic evaluation and ImmunoCyt testing of voided urine, as well as imaging studies. Urine samples were also obtained from the UT of 32 patients by ureteral catheterization and tested by cytologic analysis and ImmunoCyt.
Sixteen patients had UT-TCC as documented by the final histologic evaluation. The sensitivity of testing the voided urine from 37 patients was 50% for cytologic analysis, 75% for ImmunoCyt, and 87% for both methods combined. The cytologic evaluation detected no G1, 1 (17%) of 6 G2, and 7 (100%) of 7 G3 tumors. ImmunoCyt detected 1 (33%) of 3 G1, 6 (100%) of 6 G2, and 5 (71%) of 7 G3 tumors. The sensitivity in the 32 urine samples obtained from the UT was 82% for cytologic analysis, 91% for ImmunoCyt, and 100% for both methods combined. Cytologic analysis detected all G2 and G3 (100% sensitivity) and no G1 tumors. ImmunoCyt detected 2 (100% sensitivity) of 2 G1, 4 (100%) of 4 G2, and 4 (80%) of 5 G3 tumors. The test specificity, calculated in 21 patients free of TCC, was 100% for cytologic analysis in voided and ureteral urine specimens and 95% and 100% for ImmunoCyt in voided and ureteral urine samples, respectively.
The results of this preliminary study show that ImmunoCyt complements cytologic analysis in detecting UT-TCC, mainly because of its high sensitivity to low-grade TCC. The combination of cytologic testing and ImmunoCyt gives 100% sensitivity in detecting UT-TCC in UT urine samples.
评估免疫细胞化学检测法（ImmunoCyt）在上尿路移行细胞癌（UT-TCC）检测中的临床性能。这种新开发的免疫细胞化学检测法可检测出三种TCC特异性细胞标志物。
对37例有提示UT肿瘤的症状和/或影像学检查结果的患者进行前瞻性评估。所有患者均接受了标准细胞学评估、对晨尿进行ImmunoCyt检测以及影像学检查。还通过输尿管插管从32例患者的上尿路获取尿液样本，并进行细胞学分析和ImmunoCyt检测。
最终组织学评估证实16例患者患有UT-TCC。对37例患者晨尿检测的敏感性，细胞学分析为50%，ImmunoCyt为75%，两种方法联合检测为87%。细胞学评估未检测到G1期肿瘤，6例G2期肿瘤中检测到1例（17%），7例G3期肿瘤中检测到7例（100%）。ImmunoCyt检测到3例G1期肿瘤中的1例（33%），6例G2期肿瘤中的6例（100%），7例G3期肿瘤中的5例（71%）。从32例患者上尿路获取的尿液样本检测敏感性，细胞学分析为82%，ImmunoCyt为91%，两种方法联合检测为100%。细胞学分析检测到所有G2期和G3期肿瘤（敏感性100%），未检测到G1期肿瘤。ImmunoCyt检测到2例G1期肿瘤中的2例（敏感性100%），4例G2期肿瘤中的4例（100%），5例G3期肿瘤中的4例（80%）。在21例无TCC的患者中计算得出的检测特异性，晨尿和输尿管尿液样本的细胞学分析均为100%，晨尿和输尿管尿液样本的ImmunoCyt分别为95%和100%。
这项初步研究结果表明，ImmunoCyt在检测UT-TCC方面可补充细胞学分析，主要是因为其对低级别TCC具有高敏感性。细胞学检测和ImmunoCyt联合检测在检测上尿路尿液样本中的UT-TCC时敏感性达100%。
