陆军军医大学学报 (Sep 2022)
Diagnostic value of liquid-based cytology, DNA ploidy and fluorescence in situ hybridization in upper tract urothelial carcinoma
Abstract
Objective To investigate the application value of liquid-based cytology, DNA ploidy and fluorescence in situ hybridization (FISH) in the diagnosis of upper tract urothelial carcinoma (UTUC). Methods From January 2013 to June 2021, 246 cases with suspected UTUC on CT or MRI images in the Army Medical Center of PLA were recruited and retrospectively analyzed. Among them, 190 cases were pathologically diagnosed as UTUC, 43 cases non-tumor lesions, and 13 cases other types of tumors. All the 246 cases were examined with liquid-based cytology of voided urine, 178 cases were also with DNA ploidy analysis and 167 cases with FISH. The diagnostic accuracy of liquid-based cytology, DNA ploidy and FISH alone or in combination was calculated and compared. Results The sensitivities of liquid-based cytology, DNA ploidy and FISH in the diagnosis of UTUC were 44.7%, 82.2%, and 57.9%, respectively; the specificities were 97.7%, 82.4%, and 92.3%, respectively. The diagnostic sensitivities of the above 3 methods for high-grade UTUC were 48.1%, 87.7%, and 60.7%, respectively, and for low-grade UTUC 25.0%, 52.4%, and 37.5%, respectively. When any one of the 3 methods is positive, the diagnostic sensitivity was increased to 93.8% (compared with the 3 methods being used alone, all P < 0.05). When any 2 of them were positive at the same time as the criteria for diagnosing UTUC (both negative or only 1 positive was regarded as negative), the positive predictive value and specificity of this combined diagnostic method were both 100%. Conclusion Urinary liquid-based cytology, DNA ploidy and FISH all are clinically valuable in the diagnosis of UTUC. The combination of the 3 methods can effectively improve the sensitivity or specificity of diagnosis, thereby helping to reduce the risk of missed diagnosis or misdiagnosis.
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