Xpert® BC 检测、膀胱 Epicheck®、Urovysion® FISH 和细胞学在检测上尿路上皮癌中的诊断价值。
Diagnostic value of Xpert® BC Detection, Bladder Epicheck®, Urovysion® FISH and cytology in the detection of upper urinary tract urothelial carcinoma.
机构信息
University of Bern, Faculty of Medicine, Bern, Switzerland.
Department of Urology, Provincial Hospital of Bolzano, Lorenz Böhler St 5, 39100, Bolzano, Italy.
出版信息
World J Urol. 2023 May;41(5):1323-1328. doi: 10.1007/s00345-023-04350-x. Epub 2023 Mar 16.
PURPOSE
Following the current guidelines, diagnosis and staging for upper urinary tract tumours (UTUC) can be performed with Computed Tomography, urography, ureterorenoscopy (URS) and selective cytology. The aim of the study was to evaluate the performance of the Xpert®-BC-Detection and the Bladder-Epicheck®-test in the detection of UTUC and compare it with cytology and the Urovysion®-FISH test using histology and URS as gold standard.
METHODS
A total of 97 analyses were collected through selective catheterization of the ureter before URS to test for cytology, Xpert®-BC-Detection, Bladder-Epicheck® and Urovysion®-FISH. Sensitivity, specificity, and predictive values were calculated using histology results/URS as reference.
RESULTS
Overall sensitivity was 100% for Xpert®-BC-Detection, 41.9% for cytology, 64.5% for Bladder-Epicheck® and 87.1% for Urovysion®-FISH. The sensitivity of Xpert®-BC-Detection was 100% in both, LG and HG tumours, sensitivity of cytology increased from 30.8% in LG to 100% in HG, for Bladder-Epicheck® from 57.7% in LG to 100% in HG and of Urovysion®-FISH from 84.6% in LG to 100% in HG tumours. Specificity was 4.5% for Xpert®-BC-Detection, 93.9% for cytology, 78.8% for Bladder-Epicheck® and 81.8% for Urovysion®-FISH. PPV was 33% for Xpert®-BC-Detection, 76.5% for cytology, 58.8% for Bladder-Epicheck® and 69.2% for Urovysion®FISH. NPV was 100% for Xpert®-BC-Detection, 77.5% for cytology, 82.5% for Bladder-Epicheck® and 93.1% for Urovysion®FISH.
CONCLUSION
Bladder-Epicheck® and Urovysion®FISH along with cytology could be a helpful ancillary method in the diagnosis and follow-up of UTUC while due to its low specificity Xpert®-BC Detection seems to be of limited usefulness.
目的
根据当前的指南，上尿路肿瘤（UTUC）的诊断和分期可以通过计算机断层扫描、尿路造影、输尿管镜检查（URS）和选择性细胞学检查来完成。本研究的目的是评估 Xpert®-BC-Detection 和 Bladder-Epicheck®-test 在检测 UTUC 方面的性能，并将其与细胞学以及 Urovysion®-FISH 检测进行比较，以组织学和 URS 作为金标准。
方法
通过选择性输尿管插管，在进行 URS 之前收集了 97 例分析，以测试细胞学、Xpert®-BC-Detection、Bladder-Epicheck®和 Urovysion®-FISH。使用组织学结果/URS 作为参考，计算敏感性、特异性和预测值。
结果
Xpert®-BC-Detection 的总敏感性为 100%，细胞学为 41.9%，Bladder-Epicheck®为 64.5%，Urovysion®-FISH 为 87.1%。Xpert®-BC-Detection 在 LG 和 HG 肿瘤中的敏感性均为 100%，细胞学的敏感性从 LG 的 30.8%增加到 HG 的 100%，Bladder-Epicheck®从 LG 的 57.7%增加到 HG 的 100%，Urovysion®-FISH 从 LG 的 84.6%增加到 HG 的 100%。Xpert®-BC-Detection 的特异性为 4.5%，细胞学为 93.9%，Bladder-Epicheck®为 78.8%，Urovysion®-FISH 为 81.8%。PPV 为 Xpert®-BC-Detection 的 33%，细胞学的 76.5%，Bladder-Epicheck®的 58.8%，Urovysion®-FISH 的 69.2%。NPV 为 Xpert®-BC-Detection 的 100%，细胞学的 77.5%，Bladder-Epicheck®的 82.5%，Urovysion®-FISH 的 93.1%。
结论
Bladder-Epicheck®和 Urovysion®FISH 联合细胞学检查可作为 UTUC 诊断和随访的辅助方法，而由于其特异性较低，Xpert®-BC 检测似乎用处有限。
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