High performance of 5-aminolevulinic acid-induced fluorescent selective upper tract urinary cytology

© 2020 The Japanese Urological Association..

OBJECTIVES: To investigate the efficacy of selective upper tract urinary cytology using extracorporeal 5-aminolevulinic acid for the diagnosis of upper urinary tract urothelial carcinoma.

METHODS: We evaluated 104 patients who underwent radical nephroureterectomy and were diagnosed pathologically as having upper urinary tract urothelial carcinoma between March 2013 and May 2019 in Osaka Rosai Hospital. Preoperatively, we collected upper tract urinary cytology from both sides, and compared the sensitivity and specificity between conventional urine cytology and 5-aminolevulinic acid-induced fluorescent urine cytology.

RESULTS: The sensitivity of 5-aminolevulinic acid-induced fluorescent selective upper tract urinary cytology was significantly higher than conventional cytology (90.4% vs 66.3%, P < 0.001), whereas the specificity was equally high (100% vs 98.2%, P = 1.0). In more detailed analysis, the sensitivity of 5-aminolevulinic acid-induced fluorescent selective upper tract urinary cytology was significantly higher than that of conventional cytology unrelated to patients' age (<76 years: 90.2% vs 68.6%, P = 0.013; ≥76 years: 90.6% vs 64.2%, P = 0.021), sex (male: 89.2% vs 67.5%, P = 0.001; female: 95.2% vs 61.9%, P = 0.02) or pT stage (pT1 or less: 91.4% vs 69.0%, P = 0.005; pT2 or more: 89.1% vs 63.0%, P = 0.006), tumor grade (high grade: 91.0% vs 70.5%, P = 0.002; low grade: 88.5% vs 53.8%, P = 0.013), and tended to be more efficacious for tumors that could not be detected by imaging techniques (83.3% vs 50.0%, P = 0.075).

CONCLUSIONS: 5-Aminolevulinic acid-induced fluorescent selective upper tract urinary cytology is more sensitive than conventional cytology for the diagnosis of upper urinary tract urothelial carcinoma, regardless of pT stage and tumor grade.

Errataetall:

CommentIn: Int J Urol. 2020 Mar;27(3):218. - PMID 32023662

Media Type:

Electronic Article

Year of Publication:

2020

Contained In:

International journal of urology : official journal of the Japanese Urological Association - Vol. 27, No. 3 (2020), p. 213-218

Language:

English

Contributors:

Yamamichi, Gaku
Nakata, Wataru
Yoshimura, Akihiro
Tsujimura, Go
Tsujimoto, Yuichi
Nin, Mikio
Mimura, Akihiro
Miwa, Hideaki
Tsujihata, Masao

Urls:

Volltext

Keywords:

5-aminolevulinic acid
Journal Article
Selective upper tract urinary cytology
Sensitivity
Specificity
Upper urinary tract urothelial carcinoma

Notes:

Date Revised 15.07.2020

published: Print-Electronic

CommentIn: Int J Urol. 2020 Mar;27(3):218. - PMID 32023662

Citation Status In-Process

Copyright: From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Physical Description:

Online-Ressource

doi:

10.1111/iju.14170

PMID:

31916332

PPN (Catalogue-ID):

NLM305878573