- 标题
- 摘要
- 关键词
- 实验方案
- 产品
-
Fluorescence in situ hybridization in 1?mL of selective urine for the detection of upper tract urothelial carcinoma: a feasibility study
摘要： Kidney-sparing surgery of upper tract urothelial carcinoma (UTUC) requires a stringent follow-up with frequent ureteroscopies. Triage testing could reduce the number of follow-up ureteroscopies and hence minimize the invasiveness of follow-up. The use of urine-based markers for triage seems appealing but should be feasible with selective urine from outpatient cystoscopy to maximize the reduction of invasiveness. In this study, the feasibility of UroVysion? fluorescence in?situ hybridization (FISH) for the detection of UTUC in 1?mL of selective urine is investigated. Ten consecutive patients with biopsy-proven UTUC and five patients with negative diagnostic ureteroscopy findings were included in this case-control study. During ureteroscopy, 1?mL of selective urine was collected passively with a ureteral splint for Urovysion? FISH. The FISH rater was blinded to any clinical information. The results of FISH were compared to the findings of concomitantly collected selective urine cytology and the patients’ UTUC status. FISH was feasible in all samples with a sensitivity of 90% and a specificity of 80% for UTUC. In comparison, selective cytology resulted in a diagnostic yield of 87% with a sensitivity of 80% and a specificity of 67%. In conclusion,?UTUC detection is feasible with FISH in 1?mL of passively collected selective urine. Thus from a technical point of view, FISH could be used as an outpatient triage test to decide if follow-up ureteroscopy is necessary after kidney-sparing surgery of UTUC. Evaluation of the diagnostic accuracy of FISH for the suggested pathway deserves further attention.
关键词： Ureteroscopy,Urothelial carcinoma,Cystoscopy,Fluorescence in?situ hybridization,Urine cytology,Upper tract urothelial carcinoma
更新于2025-09-23 15:21:21
-
Combination of holmium and thulium laser ablation in upper tract urothelial carcinoma
摘要： Thanks to the latest technological and technical advances in endourology, the management of upper tract urothelial cancer (UTUC) has changed over the last years, with expanding indications for a conservative approach. The endourological management has been described by means of flexible ureteroscopes and of holmium:YAG fibre lasers. A systematic review showed that oncologic outcomes at 5 and 10 years of follow-up were similar by comparing cohorts of low-risk UTUC patients undertaking either nephroureterectomy or endourological ablation. Accordingly, since 2018 the European Association of Urology Guidelines on UTUC have recommended the elective conservative management of UTUC in selected patients with low-risk lesions, i.e., those 2 cm in size, solitary, low-grade, non-muscle-infiltrative and without upper urinary tract dilatation at CT scan. More recently, the use of thulium laser (TL) has been described in the context of UTUC: as far as it concerns the technical features, TL consists of a diode-pumped laser that provides a continuous wave and a lower tissue penetration, which allow for a more precise vaporization, excellent coagulation, and a lower risk of injury to normal tissue, making it the ideal laser to deal with soft tissue disease. In 2011, Defidio et al., in a series of 59 cases of UTUC, demonstrated that the thulium laser ablation was non-inferior to holmium:YAG laser ablation in terms of oncological outcomes. More recently, Musi et al. reported the outcomes of the largest published cohort of UTUC patients (n = 42) undertaking thulium laser vaporization: the authors showed oncological outcomes comparable to those available in literature, with a recurrence-free survival of 81% at a median of 44 months of follow-up, and a very low rate of complications.
关键词： UTUC,thulium laser,endourology,holmium laser,upper tract urothelial carcinoma
更新于2025-09-23 15:19:57
-
Ex-vivo Imaging of Upper Tract Urothelial Carcinoma Using Novel ICG-Var3 pHLIP Imaging Agent
摘要： Objectives: To improve visualization of upper tract urothelial carcinomas (UTUC). Previous studies using the novel pH low insertion peptide (pHLIP) variant 3 (Var3) conjugated to indocyanine green (ICG) have demonstrated high sensitivity and specificity for imaging of bladder urothelial carcinoma. Here, we describe a novel approach for the imaging of UTUC using ICG-Var3 pHLIP. Methods: Twelve ex-vivo upper urinary tract specimens were irrigated with ICG-Var 3 pHLIP for fifteen minutes and then examined using a white light laparoscopic camera followed by near infrared fluorescent (NIRF) imaging using a Stryker 1588 AIM imaging system. Standard histopathologic evaluation was performed and findings were correlated with white light and ICG-Var3 NIRF imaging. One patient who underwent radical nephrectomy for renal cell carcinoma was used as a negative control. Results: Nineteen lesions were identified on histopathologic evaluation in ten patients, including 82% high-grade urothelial carcinoma and 18% low-grade urothelial carcinoma. Nineteen (100%) malignant lesions were identified using NIRF imaging, while 15 (78.9%) lesions were identified using conventional white light examination. The sensitivity of ICG-Var3 pHLIP NIRF imaging was 100% compared to 78.9% white light examination. Both modalities are 100% specific. Benign collecting systems and ureters did not show uptake of the pHLIP construct. Conclusions: In this feasibility study, the ICG-Var3 pHLIP imaging agent demonstrated superior diagnostic performance compared to conventional white light examination. While additional studies are required for validation and in-vivo translation, pHLIP-based imaging represents a promising tool to improve the evaluation and management of upper tract urothelial carcinoma.
关键词： urothelial carcinoma,pHLIP,fluorescence,NIRF,near infrared imaging
更新于2025-09-19 17:15:36
-
Molecular Diagnostics in Cytopathology (A Practical Handbook for the Practicing Pathologist) || Fluorescence In Situ Hybridization (FISH) Testing in Urinary Tract Cytology
摘要： Fluorescence in situ hybridization (FISH) allows for visualization of specific DNA sequences and can, therefore, be used for quantitation of chromosomes and genes, including aneusomies, chromosomal deletions, or amplifications. The commercial assay UroVysion? (Vysis, Inc., Downers Grove, IL, USA) has made the FISH technique available for routine use in hospital cytology laboratories, but most UroVysion? tests are performed at large reference laboratories. The UroVysion? assay is composed of four single-stranded fluorescently labeled nucleic acid probes – three chromosome enumeration probes (CEP) for the chromosomes 3, 7, and 17 and the single locus-specific identifier (LSI) probe 9p21. The DNA probes are directly labeled with the four different fluorescent dyes SpectrumRed (CEP3), SpectrumGreen (CEP7), SpectrumAqua (CEP17), and SpectrumGold (LSI 9p21).
关键词： UroVysion?,locus-specific identifier,Fluorescence in situ hybridization,urothelial carcinoma,urinary cytology,FISH,chromosome enumeration probes
更新于2025-09-10 09:29:36