Murahashi Norihiro, Abe Takashige, Shinohara Nobuo, Murai Sachiyo, Harabayashi Toru, Sazawa Ataru, Maruyama Satoru, Tsuchiya Kunihiko, Miyajima Naoto, Hatanaka Kanako, Nonomura Katsuya
Department of Urology, Hokkaido University Graduate School of Medicine, North-15, West-7, North Ward, Sapporo, 060-8638, Japan.
Department of Urology, Hokkaido Cancer Center, Sapporo, Japan.
BMC Urol. 2015 Sep 4;15:92. doi: 10.1186/s12894-015-0086-6.
To determine the incidence of later cancer detection and its risk factors after the first diagnostic ureteroscopy.
One hundred and sixty-six patients undergoing diagnostic ureteroscopy based on the suspicion of urothelial carcinoma of the upper urinary tract (UC of the UUT) between 1995 and 2012 were included. We examined the diagnostic outcome of the initial ureteroscopy. Thereafter, we collected follow-up data on patients who had not been diagnosed with UC of the UUT at the first examination, and evaluated the incidence of later cancer detection and its risk factors using Cox hazard models.
Of the 166 patients, 76 (45.8%) were diagnosed with UC of the UUT at the first diagnostic ureteroscopy. The remaining 90 (54.2%) were diagnosed with other malignancies (n = 22), non-malignant disorders (n = 18), or without disorders (n = 50). Of these 90 patients, follow-up data were available in 65 patients (median: 41 months, range: 3-170). During the follow-up, carcinoma was detected in 6 patients (6/65, 9.2%) at a median of 43.5 months (range: 10-59). Episodes of gross hematuria (p = 0.0048) and abnormal cytological findings (p = 0.0335) during the follow-up and a male sex (p = 0.0316) were adverse risk factors.
Later cancer detection of UC of the UUT was not uncommon after the first examination. The risk analysis revealed the aforementioned characteristics.
确定首次诊断性输尿管镜检查后晚期癌症的检出率及其危险因素。
纳入1995年至2012年间因怀疑上尿路尿路上皮癌（UUT的UC）而接受诊断性输尿管镜检查的166例患者。我们检查了初次输尿管镜检查的诊断结果。此后，我们收集了首次检查时未被诊断为UUT的UC的患者的随访数据，并使用Cox风险模型评估了晚期癌症的检出率及其危险因素。
166例患者中，76例（45.8%）在首次诊断性输尿管镜检查时被诊断为UUT的UC。其余90例（54.2%）被诊断为其他恶性肿瘤（n = 22）、非恶性疾病（n = 18）或无疾病（n = 50）。在这90例患者中，65例患者有随访数据（中位数：41个月，范围：3 - 170个月）。在随访期间，6例患者（6/65，9.2%）在中位时间43.5个月（范围：10 - 59个月）时检测到癌症。随访期间肉眼血尿发作（p = 0.0048）、细胞学检查异常（p = 0.0335）以及男性（p = 0.0316）是不良风险因素。
首次检查后UUT的UC晚期癌症检出并不罕见。风险分析揭示了上述特征。
