Keeley F X, Kulp D A, Bibbo M, McCue P A, Bagley D H
Department of Urology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
J Urol. 1997 Jan;157(1):33-7.
Our aim was to determine the accuracy of ureteroscopic biopsies and cytological techniques compared to open surgical specimens of upper tract transitional cell carcinoma.
From 1985 to 1995, 51 cases of upper tract transitional cell carcinoma were diagnosed ureteroscopically and distal ureterectomy or nephroureterectomy was performed. Each patient underwent direct ureteroscopic inspection and biopsy. Fresh samples were delivered to the cytopathology laboratory, where they were examined using cytospin and smear. A cell block was prepared when visible tissue was present. Grades of ureteroscopic biopsies were compared to grades and stages of surgical specimens in 42 cases.
Cytological evaluation was positive for malignancy in 48 of the 51 cases (94.1%). Grading of ureteroscopic specimens was possible in 42 cases (82.4%). Transitional cell carcinoma grade on ureteroscopy accurately predicted tumor grade and stage in the surgical specimens. Of 30 low or moderate grade ureteroscopic specimens 27 (90%) proved to be low or moderate grade transitional cell carcinoma in the surgical specimens, while 11 of the 12 high grade ureteroscopic specimens (91.6%) proved to be high grade transitional cell carcinoma (p < 0.0001). Of 30 low or moderate grade ureteroscopic specimens 26 (86.6%) had a low stage (Ta or T1) tumor. In contrast, 8 of 12 high grade ureteroscopic specimens (66.7%) had invasive tumor (stage T2 or T3) in the surgical specimen (p = 0.0006).
Ureteroscopic inspection and biopsy combined with cytological techniques provide accurate information regarding grade and stage of upper tract transitional cell carcinoma.
我们的目的是确定输尿管镜活检和细胞学技术与上尿路移行细胞癌开放手术标本相比的准确性。
1985年至1995年，51例上尿路移行细胞癌经输尿管镜诊断，并进行了远端输尿管切除术或肾输尿管切除术。每位患者均接受了直接输尿管镜检查和活检。新鲜样本被送至细胞病理学实验室，在那里使用细胞离心涂片法和涂片进行检查。当存在可见组织时制备细胞块。将42例输尿管镜活检的分级与手术标本的分级和分期进行比较。
51例中有48例（94.1%）细胞学评估为恶性阳性。42例（82.4%）可对输尿管镜标本进行分级。输尿管镜检查时的移行细胞癌分级准确预测了手术标本中的肿瘤分级和分期。30例低级别或中级别输尿管镜标本中，27例（90%）在手术标本中被证实为低级别或中级别移行细胞癌，而12例高级别输尿管镜标本中的11例（91.6%）在手术标本中被证实为高级别移行细胞癌（p<0.0001）。30例低级别或中级别输尿管镜标本中，26例（86.6%）肿瘤分期较低（Ta或T1）。相比之下，12例高级别输尿管镜标本中的8例（66.7%）在手术标本中有浸润性肿瘤（T2或T3期）（p=0.0006）。
输尿管镜检查和活检结合细胞学技术可提供有关上尿路移行细胞癌分级和分期的准确信息。
