Savin Ziv, Gupta Kavita, Lundon Dara, Frangopoulos Eve, Ricapito Anna, Durbhakula Vinay, Gallante Blair, Atallah William M, Kyprianou Natasha, Gupta Mantu
Department of Urology, Icahn School of Medicine at Mount Sinai New York, NY, USA.
Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai New York, NY, USA.
Am J Clin Exp Urol. 2025 Jun 15;13(3):249-255. doi: 10.62347/GOQW9515. eCollection 2025.
The predictive value of blood and serum markers for spontaneous ureteral stone passage (SSP) has been investigated, with no substantial conclusion about their reliability. Therefore, we aim to evaluate the predictive potential of blood and urine laboratory tests for ureteral stone passage.
This prospective, single-center observational study included patients with a solitary obstructing ureteral stone <10 mm diagnosed via non-contrast computerized tomography (NCCT). Definition for SSP was strict including physical evidence of stone passage, follow-up NCCT, or ureteroscopy, and patients were followed until stone passage or urologic intervention occurred. Blood and urine markers, including white blood cells count (WBC), neutrophil-to-lymphocyte ratio (NLR), creatinine, calculated glomerular filtration rates, urine leukocyte esterase and nitrates were collected. Univariate analysis, multivariate analysis, and receiver operating characteristic curves were performed to assess the association between markers and SSP.
Cohort consisted of 165 participants who met the inclusion and exclusion criteria with adequate data collection and follow-up. Median age was 54 years with a male to female ratio of 11:5. Most stones were in the mid-distal ureter (56%) and median stone size was 3.5 mm. SSP was observed in 87 patients (53%). None of the blood or urine markers demonstrated a significant association with SSP, and areas under the curves were poor and insignificant. Smaller stone size and distal location significantly predicted SSP.
Routine blood and urine markers are not associated with SSP, and their contribution to SSP nomograms might be negligible. These negative results may redirect providers' focus to other factors when predicting SSP.
已对血液和血清标志物对输尿管结石自然排出（SSP）的预测价值进行了研究，但关于其可靠性尚无实质性结论。因此，我们旨在评估血液和尿液实验室检查对输尿管结石排出的预测潜力。
这项前瞻性、单中心观察性研究纳入了通过非增强计算机断层扫描（NCCT）诊断为单发梗阻性输尿管结石且直径<10 mm的患者。SSP的定义很严格，包括结石排出的物理证据、随访NCCT或输尿管镜检查，并且对患者进行随访，直至结石排出或进行泌尿外科干预。收集血液和尿液标志物，包括白细胞计数（WBC）、中性粒细胞与淋巴细胞比值（NLR）、肌酐、计算的肾小球滤过率、尿白细胞酯酶和硝酸盐。进行单因素分析、多因素分析和受试者工作特征曲线分析，以评估标志物与SSP之间的关联。
队列由165名符合纳入和排除标准且有充分数据收集和随访的参与者组成。中位年龄为54岁，男女比例为11:5。大多数结石位于输尿管中下段（56%），中位结石大小为3.5 mm。87例患者（53%）观察到SSP。血液或尿液标志物均未显示与SSP有显著关联，曲线下面积较差且无统计学意义。较小的结石大小和远端位置显著预测SSP。
常规血液和尿液标志物与SSP无关，它们对SSP列线图的贡献可能微不足道。这些阴性结果可能会使医疗服务提供者在预测SSP时将重点转向其他因素。
