Furukawa Junya, Miyake Hideaki, Sakai Iori, Fujisawa Masato
Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan.
Curr Urol. 2013 Jan;6(3):156-9. doi: 10.1159/000343531. Epub 2012 Dec 21.
The objective of this study was to assess the significance of the ureteroscopic biopsy grade for patients with upper tract urothelial carcinoma (UTUC).
This study included 40 patients who were diagnosed with a single focus of UTUC by ureteroscopic biopsy and subsequently underwent nephroureterectomy. The significance of the biopsy grade as a predictive factor for pathological outcomes of nephroureterectomy was retrospectively analyzed.
Of these 40 patients, 19 (47.5%) and 21 (52.5%) were diagnosed with low and high grade UTUC, respectively. The ureteroscopic biopsy grade matched the pathological grade of surgically resected specimens in 35 of the 40 cases (87.5%), and there was a significant correlation between the biopsy and pathological grades (p < 0.001). Furthermore, the biopsy grade was also shown to be closely associated with the pathological stage (p < 0.001); that is, only 1 of the 19 patients (5.3%) with biopsy low grade UTUC were pathologically diagnosed as having muscle invasive disease, while 17 of the 21 patients (81.0%) with biopsy high grade UTUC appeared to show tumor invasion into muscle or deeper.
The grade of UTUC on ureteroscopic biopsy could provide accurate diagnostic information on the final pathology of nephroureterectomy specimens.
本研究的目的是评估输尿管镜活检分级对上尿路尿路上皮癌（UTUC）患者的意义。
本研究纳入了40例经输尿管镜活检诊断为单一病灶UTUC并随后接受肾输尿管切除术的患者。回顾性分析活检分级作为肾输尿管切除病理结果预测因素的意义。
这40例患者中，分别有19例（47.5%）和21例（52.5%）被诊断为低级别和高级别UTUC。40例中有35例（87.5%）输尿管镜活检分级与手术切除标本的病理分级相符，活检分级与病理分级之间存在显著相关性（p < 0.001）。此外，活检分级也与病理分期密切相关（p < 0.001）；也就是说，19例活检低级别UTUC患者中只有1例（5.3%）病理诊断为肌层浸润性疾病，而21例活检高级别UTUC患者中有17例（81.0%）似乎显示肿瘤侵犯至肌肉或更深层。
输尿管镜活检的UTUC分级可为肾输尿管切除标本的最终病理提供准确的诊断信息。
