The diagnosis of upper tract urothelial carcinoma (UTUC) can be a challenging diagnostic
pursuit. To date, there is no large-scale study assessing the statistical utility
(eg, sensitivity and specificity) of selective cytology. Herein, we systematically
reviewed and meta-analyzed the published literature to evaluate the efficacy of selective
cytology for the detection of UTUC in patients with a suspicious clinical profile
Selective cytology confers a high specificity but marginal sensitivity for the detection
of UTUC. The sensitivity is greater for high-grade UTUC lesions. The statistical assessment
of its utility is limited by the heterogeneity and bias of previous studies.
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References
- Upper tract urothelial neoplasms: incidence and survival during the last 2 decades.J Urol. 2000; 164: 1523-1525https://doi.org/10.1016/S0022-5347(05)67019-X
- European Association of Urology Guidelines on Upper Urinary Tract Urothelial Cell Carcinoma: 2015 Update.Eur Urol. 2015; 68: 868-879https://doi.org/10.1016/j.eururo.2015.06.044
- Performance of computed tomographic urography in diagnosis of upper urinary tract urothelial carcinoma in patients presenting with hematuria: systematic review and meta-analysis.Eur J Radiol. 2010; 73: 334-338https://doi.org/10.1016/j.ejrad.2008.10.026
- Detection of upper urinary tract transitional cell carcinoma with ImmunoCyt: a preliminary report.Urology. 2001; 58: 362-366https://doi.org/10.1016/S0090-4295(01)01182-7
- The BTA stat test: a tumor marker for the detection of upper tract transitional cell carcinoma.Urology. 2001; 58: 532-535https://doi.org/10.1016/S0090-4295(01)01307-3
- Upper urinary tract washing in the diagnosis of transitional cell carcinoma of the renal pelvis and calices. A comparison with voided urine.Rom J Morphol Embryol. 1995; 41: 101-105
- The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration.Ann Intern Med. 2009; 151: W65-W94https://doi.org/10.7326/0003-4819-151-4-200908180-00136
- World Health Organization Classification of Tumours.in: Pathology and Genetics of Tumours of the Urinary System and Male Genital Organs. IARC Press, Lyon2004
- Review of the state of the art and recommendations of the Papanicolaou Society of Cytopathology for urinary cytology procedures and reporting: the Papanicolaou Society of Cytopathology practice guidelines task force.Diagn Cytopathol. 2004; 30: 24-30https://doi.org/10.1002/dc.10401
- Comparison of urine cytology and fluorescence in situ hybridization in upper urothelial tract samples.Cancer Cytopathol. 2014; 122: 459-467https://doi.org/10.1002/cncy.21414
- Comparison of 2004 and 1973 World Health Organization grading systems and their relationship to pathologic staging for predicting long-term prognosis in patients with urothelial carcinoma.Urology. 2010; 76: 593-599https://doi.org/10.1016/j.urology.2010.01.032
- QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies.Ann Intern Med. 2011; 155: 529-536https://doi.org/10.7326/0003-4819-155-8-201110180-00009
- Conducting meta-analyses in R with the metafor package.J Stat Softw. 2010; 36: 1-48https://doi.org/10.18637/jss.v036.i03
- Bias in meta-analysis detected by a simple, graphical test.BMJ. 1997; 315: 629-634
- Diagnosis of upper tract urothelial carcinoma-a comparative study of urinary cytology and surgical biopsy.J Am Soc Cytopathology. 2015; 4: 3-9https://doi.org/10.1016/j.jasc.2014.09.203
- Ureterorenoscopy for upper tract urothelial carcinoma: how often are we missing lesions?.Urology. 2015; 85: 311-315https://doi.org/10.1016/j.urology.2014.08.030
- FISH analysis of washing urine from the upper urinary tract for the detection of urothelial cancers.Int Urol Nephrol. 2014; 46: 1769-1774https://doi.org/10.1007/s11255-014-0714-1
- Exfoliative cytology of renal pelvic lesions.Cancer. 1961; 14: 1085-1087https://doi.org/10.1002/1097-0142(196109/10)14:5<1085:AID-CNCR2820140527>3.0.CO;2-K
- Significance of urinary cytology in the early detection of transitional cell cancer of the upper urinary tract.J Urol. 1976; 116: 781-783
- Lavage of cytology of the renal pelvis and ureter with special reference to tumors.J Urol. 1980; 124: 597-600
- Transitional carcinoma of the upper urinary tract: a histological and cytopathological study.J Clin Pathol. 1986; 39: 297-305
- Use of cytomorphometry and cytology in the diagnosis of transitional-cell carcinoma of the upper urinary tract.Acta Cytol. 1987; 31: 137-142
- Multimodal cytologic evaluation of upper urinary tract urothelial lesions.J Surg Pathol. 1995; : 31-35
- The clinical implications of telomerase activity in upper tract urothelial cancer and washings.BJU Int. 2000; 86: 213-219https://doi.org/10.1046/j.1464-410x.2000.00830.x
- Cytologic analysis of ureteral washings is informative in patients with grade 2 upper tract TCC considering endoscopic treatment.Urology. 2003; 61: 1146-1150https://doi.org/10.1016/S0090-4295(03)00026-8
- Correlation of upper-tract cytology, retrograde pyelography, ureteroscopic appearance, and ureteroscopic biopsy with histologic examination of upper-tract transitional cell carcinoma.J Endourol. 2008; 22: 71-76https://doi.org/10.1089/end.2007.9853
- Fluorescence in situ hybridisation in the diagnosis of upper urinary tract tumours.Eur Urol. 2010; 58: 288-292https://doi.org/10.1016/j.eururo.2010.04.026
- Diagnostic value of the nuclear matrix protein 22 test and urine cytology in upper tract urothelial tumors.Urol Int. 2011; 87: 134-137https://doi.org/10.1159/000330246
- Significance of ureteroscopic biopsy grade in patients with upper tract urothelial carcinoma.Curr Urol. 2012; 6: 156-159https://doi.org/10.1159/000343531
- Ureterorenoscopic biopsy and urinary cytology according to the 2004 WHO classification underestimate tumor grading in upper urinary tract urothelial carcinoma.Urol Oncol. 2013; 31: 1166-1170https://doi.org/10.1016/j.urolonc.2011.12.021
- The merits of cytology in the workup for upper tract urothelial carcinoma—a contemporary review of a perplexing issue.Int Braz J Urol. 2014; 40: 493-498https://doi.org/10.1590/S1677-5538.IBJU.2014.04.07
- Risk group stratification based on preoperative factors to predict survival after nephroureterectomy in patients with upper urinary tract urothelial carcinoma.Ann Surg Oncol. 2013; 20: 4389-4396https://doi.org/10.1245/s10434-013-3259-0
- Endoscopic brush cytology of the upper urinary tract. Evaluation of its efficacy and potential limitations in diagnosis.Acta Cytol. 1997; 41: 377-384
- Grading of upper urinary tract transitional cell carcinoma by computed DNA content and.Urology. 1997; 50 (p53 expression)https://doi.org/10.1016/s0090-4295(97)00404-4
- Diagnostic accuracy and key cytologic features of high-grade transitional cell carcinoma in the upper urinary tract.Mod Pathol. 1997; 10: 657-662
- Transitional cell carcinoma of the renal pelvis the diagnostic role of pelvic washings.Am J Clin Pathol. 2002; 117: 444-450https://doi.org/10.1309/hc0u-8mel-9ggv-g9ew
- Conservative elective treatment of upper urinary tract tumors: a multivariate analysis of prognostic factors for recurrence and progression.J Urol. 2003; 169: 82-85https://doi.org/10.1016/S0022-5347(05)64041-4
- A comparative analysis of rapid urine tests for the diagnosis of upper urinary tract malignancy.Can J Urol. 2003; 10: 1754-1758
- Abnormal selective cytology results predict recurrence of upper-tract transitional-cell carcinoma treated with ureteroscopic laser ablation.J Endourol. 2004; 18: 912-916https://doi.org/10.1089/end.2004.18.912
- Comparison of ureteral washing and biopsy specimens in the community setting.Cancer. 2006; 108: 45-48https://doi.org/10.1002/cncr.21456
- Fluorodeoxyglucose positron emission tomography/computed tomography for diagnosis of upper urinary tract urothelial carcinoma.Int J Clin Oncol. 2015; 20: 1042-1047https://doi.org/10.1007/s10147-015-0817-4
- Accuracy and risk of malignancy for diagnostic categories in urine cytology at a large tertiary institution.Cancer Cytopathol. 2015; 123: 10-18https://doi.org/10.1002/cncy.21477
- Upper tract urinary cytology to detect upper tract urothelial carcinoma: using the Johns Hopkins Hospital template and evaluation of its feasibility.Cytojournal. 2015; 12: 17https://doi.org/10.4103/1742-6413.161608
- Small endoscopic biopsies of the ureter and renal pelvis: pathologic pitfalls.Am J Surg Pathol. 2009; 33: 1540-1546https://doi.org/10.1097/PAS.0b013e3181aec42a
- Tumor markers in the diagnosis of primary bladder cancer. A systematic review.J Urol. 2003; 169: 1975-1982https://doi.org/10.1097/01.ju.0000067461.30468.6d
- Current practice patterns in urologic management of upper-tract transitional-cell carcinoma.J. Endourol. 2005; 19: 366-371https://doi.org/10.1089/end.2005.19.366
- MDCT urography of upper tract urothelial neoplasms.AJR Am J Roentgenol. 2005; 184: 1873-1881https://doi.org/10.2214/ajr.184.6.01841873
- European Association of Urology Guidelines on upper urinary tract urothelial cell carcinoma: 2015 update.Eur Urol. 2015; https://doi.org/10.1016/j.eururo.2015.06.044
- Preoperative C-reactive protein in the serum: a prognostic biomarker for upper urinary tract urothelial carcinoma treated with radical nephroureterectomy.Urol Int. 2014; 93: 352-360https://doi.org/10.1159/000362248
- Quantitative measurement of cancer tissue biomarkers in the lab and in the clinic.Lab Invest. 2015; 95: 385-396https://doi.org/10.1038/labinvest.2014.157
- Feasibility of obtaining biomarker profiles from endoscopic biopsy specimens in upper tract urothelial carcinoma: preliminary results.Urol Oncol. 2015; 33: e21-e26https://doi.org/10.1016/j.urolonc.2014.09.017
- Multi-institutional validation of the predictive value of Ki-67 in patients with high grade urothelial carcinoma of the upper urinary tract.J Urol. 2015; 193: 1486-1493https://doi.org/10.1016/j.juro.2014.11.007
- Genomic biomarkers for the prediction of stage and prognosis of upper tract urothelial carcinoma.J Urol. 2016; https://doi.org/10.1016/j.juro.2016.01.006
- Combination of cytologic evaluation and quantitative digital cytometry is reliable in detecting recurrent disease in patients with urinary diversions.Cancer. 2007; 111: 323-329https://doi.org/10.1002/cncr.22950
- Optical diagnostics for upper urinary tract urothelial cancer: technology, thresholds, and clinical applications.J Endourol. 2015; 29: 113-123https://doi.org/10.1089/end.2014.0551
- Sources of variation and bias in studies of diagnostic accuracy: a systematic review.Ann Intern Med. 2004; 140: 189-202https://doi.org/10.7326/0003-4819-140-3-200402030-00010
- A review of reporting systems and terminology for urine cytology.Cancer Cytopathol. 2013; 121: 9-14https://doi.org/10.1002/cncy.21253
- Accuracy of grading of urothelial carcinoma on urine cytology: an analysis of interobserver and intraobserver agreement.Int J Clin Exp Pathol. 2012; 5: 882-891
- Prediction using hierarchical data: Applications for automated detection of cervical cancer.Stat Anal Data Min. 2015; 8: 65-74https://doi.org/10.1002/sam.11261
- Incidence of benign results after laparoscopic radical nephroureterectomy.JSLS. 2014; : 18https://doi.org/10.4293/JSLS.2014.00335
Article info
Publication history
Published online: May 02, 2016
Accepted:
April 26,
2016
Received:
March 14,
2016
Footnotes
Financial Disclosure: The authors declare that they have no relevant financial interests.
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
