- Email: [email protected]
54 IS URINE CYTOLOGY A RELEVANT INVESTIGATION FOR UROLOGICAL MALIGNANCIES?
52
COMPARISON OF MOLECULAR MARKERS, SUB-STAGE AND THE EORTC RISK-SCORE TO PREDICT CLINICAL OUTCOME OF PT1 BLADDER CANCER
9DQ5KLMQ%:*9DQ'HU.ZDVW7+%DSDW%%RVWURP3- )OHVKQHU1(9DQ'HU$D010/LX/%DQJPD&+-HZHWW0$6 =ZDUWKRᚎ(&=ORWWD$5 1 University Health Network, Dept. of Surgical Oncology (Urology), Toronto, Canada, 2University Health Network, Dept. of Pathology, Toronto, Canada, 3 Mount Sinai Hospital, Dept. of Cancer Genetics, Toronto, Canada, 4Erasmus Medical Centre, Dept. of Urology, Rotterdam, The Netherlands, 5Erasmus Medical Centre, Dept. of Pathology, Rotterdam, The Netherlands Introduction & Objectives: :H HYDOXDWHG WKH LPSDFW RI VXEVWDJH FOLQLFR SDWKRORJLFDO SDUDPHWHUV DQG PROHFXODU PDUNHUV RQ WKH FOLQLFDO RXWFRPH RI SULPDU\S7EODGGHUFDQFHU %& WUHDWHGZLWK%&* Material & Methods: 7KH VOLGHV RI SULPDU\ %& IURP 5RWWHUGDP 1/ Q DQG7RURQWR&DQDGD Q ZHUHUHYLHZHGDQGWKHS7GLDJQRVLVZDVFRQᚏUPHG 6XEVWDJLQJZDVGRQHLQWZRVHSDUDWHURXQGVXVLQJDQHZV\VWHPLHS7PLFUR LQYDVLYH S7P DQGS7H[WHQVLYHLQYDVLYH S7H >@DQGDFFRUGLQJWRLQYDVLRQ RIWKHPXVFXODULVPXFRVDH S7DS7ES7F 8QLDQGPXOWLYDULDWHDQDO\VHVIRU UHFXUUHQFHDQGSURJUHVVLRQZHUHSHUIRUPHGZLWKFOLQLFDO VL]HPXOWLSOLFLW\KRVSLWDO JHQGHU DJH SDWKRORJLFDO VXEVWDJH &,6 JUDGH DQG PROHFXODU PDUNHUV )*)5 PXWDWLRQ DQG 0,% 3 3 H[SUHVVLRQ 7KH (257& ULVN VFRUHVIRUUHFXUUHQFHDQGSURJUHVVLRQZHUHFDOFXODWHG>@ Results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ᚏFDQWLQXQLYDULDWH DQDO\VLVIRUUHFXUUHQFHZHUHPXOWLSOLFLW\ 3 DQG&,6 3 ,QPXOWLYDULDWH DQDO\VLVIRUUHFXUUHQFHPXOWLSOLFLW\ 3 55 &, ZDVWKHRQO\ VLJQLᚏFDQWYDULDEOH6LJQLᚏFDQWLQXQLYDULDWHDQDO\VLVIRUSURJUHVVLRQZHUHJHQGHU 3 VXEVWDJH PH 3 VXEVWDJH DEF 3 &,6 3 )*)5 3 0,% 3 3 3 0,%3 3 )*)5 0,% 3 DQG)*)53 3 ,QPXOWLYDULDWHDQDO\VLVIRUSURJUHVVLRQ IHPDOH JHQGHU 3 55 &, VXEVWDJH PH 3 55 &, DQG&,6 3 55 &, ZHUHWKHVLJQLᚏFDQW YDULDEOHV*UDGHDQGWKH(257&ULVNVFRUHVZHUHQHYHUVLJQLᚏFDQW Conclusions: 0XOWLSOLFLW\ ZDV WKH VWURQJHVW SUHGLFWRU RI UHFXUUHQFH ZKLOH &,6 IHPDOHJHQGHUDQGVXEVWDJH S7PS7H >@ZHUHWKHPRVWLPSRUWDQWYDULDEOHV IRUSURJUHVVLRQLQS7%&7KHDGGLWLRQDOYDOXHRIPROHFXODUPDUNHUVZDVPRGHVW 7KH YDOXH RI WKH (257& ULVNVFRUH ZDV OLPLWHG LQ WKLV SULPDU\ S7%& JURXS 5HIHUHQFHV 9DQGHU$DHWDO+XP3DWKRO %DEMXNHWDO(XU 8URO
53
IMPACT OF URINARY SAMPLING AND URINARY TRACT INFECTION ON THE DIAGNOSTIC VALUE OF URINE TESTS (UROVYSIONR, UCYT+R) AND CYTOLOGY FOR TRANSITIONAL CELL CARCINOMA – RESULTS FROM A COHORT OF 2077 PATIENTS
6FKZHQWQHU&+HQQHQORWWHU-.XHKV87HZV9&ROOHVHOOL'+XEHU6 6FKLOOLQJ'6LHYHUW.'6WHQ]O$ Eberhard-Karls University Tübingen, Dept. of Urology, Tübingen, Germany Introduction & Objectives: %HVLGH XULQH F\WRORJ\ WKH 8UR9\VLRQ5 9\VLV DQG X&\W5 'LDJQRFXUH WHVWVV\VWHPVDUHXVHGIRUWKHHDUO\GHWHFWLRQRIWUDQVLWLRQDO FHOO FDUFLQRPD 7&& :KHUHDV LQVWUXPHQWHG XULQDU\ VDPSOLQJ ,86 LV DQ H[FOXVLRQFULWHULRQIRUVHYHUDORWKHU7&&WHVWNLWVWKHUHDUHQRH[DFWVSHFLᚏFDWLRQV IRU WKH 8UR9\VLRQ DQG X&\W V\VWHPV &RQFRPLWDQW XULQDU\ WUDFW LQIHFWLRQ 87, PD\ DOVR KDYH DQ LPSDFW RQ WKH WHVW ᚏQGLQJV *LYHQ WKH ODFN RI GDWD WKHUH DUH QR UHFRPPHQGDWLRQV DYDLODEOH LI XULQDU\ WUDFW PDQLSXODWLRQ LQWHUIHUHV ZLWK WKH DIRUHPHQWLRQHG WHVWV +HUHLQ ZH HYDOXDWH WKH LPSDFW RI ,86 DQG 87, RQ XULQH F\WRORJ\WKH8UR9\VLRQ),6+WHVW 9\VLV5 DQGWKHX&\WWHVW Material & Methods: $ FRKRUW RI FRQVHFXWLYH SDWLHQWV VXVSHFWHG WR KDYH 7&& XQGHUZHQW WKH PXOWLPDUNHU WHVWLQJ RI WKH PHQWLRQHG WHVWV IROORZHG E\ F\VWRVFRS\DQGLQFDVHRIVXVSLFLRXVᚏQGLQJVWUDQVXUHWKUDOUHVHFWLRQ$OOSDWLHQWV ZHUHLQYHVWLJDWHGUHJDUGLQJWKHWHFKQLTXHRIXULQDU\VSHFLPHQKDUYHVWLQJ,86ZDV GHᚏQHGDVFDWKHWHUL]HGLUULJDWHGRUH[SULPDWHGXULQHZKHUHDVVSRQWDQHRXVYRLGLQJ ZDV GHᚏQHG DV XULQH FROOHFWHG ZLWKRXW ,86 87, ZDV GHWHUPLQHG E\ &RPEXU HYDOXDWLRQDQGXULQHPLFURVFRS\$FRQVWHOODWLRQRIุOHXFRF\WHVVLPXOWDQHRXV KHPDWXULDRUQLWULWHSRVLWLYLW\DVZHOODVVLJQLᚏFDQWEDFWHULXULDZHUHGHᚏQHGDV87, 7KHWHVWUHVXOWVZHUHFRPSDUHGZLWKUHJDUGVWRWKHLQYDVLYHQHVVRIXULQHFROOHFWLRQ DQG87,VWDWXVE\FRQWLQJHQF\DQDO\VLVDQG&KLVTXDUHWHVWVVHSDUDWHO\IRUSDWLHQWV ZLWKRXWHYLGHQFHRI7&&DQGZLWKKLVWRORJLFDOO\SURYHQ7&&
Eur Urol Suppl 2010;9(2):50
Results: ,QRISDWLHQWVXULQHZDVFROOHFWHGLQFRQMXQFWLRQZLWKXULQDU\WUDFW LQVWUXPHQWDWLRQ,QF\WRORJ\IDOVHSRVLWLYHUHVXOWVRFFXUUHGLQDQGRI SDWLHQWV ZLWKRXW DQG ZLWK ,86 UHVSHFWLYHO\ S )DOVH QHJDWLYH UHVXOWV DSSHDUHG LQ DQG RI SDWLHQWV ZLWKRXW DQG ZLWK ,86 S )RU WKH 8UR9\VLRQ WHVW IDOVH SRVLWLYH UHVXOWV RFFXUUHG LQ DQG RI SDWLHQWV ZLWKRXWDQGZLWK,86UHVSHFWLYHO\ S )DOVHQHJDWLYHUHVXOWVZHUHVHHQ LQDQGRISDWLHQWVZLWKRXWDQGZLWK,86 S )RUWKHX&\WWHVW IDOVHSRVLWLYHUHVXOWVRFFXUUHGLQDQGRISDWLHQWVZLWKRXWDQGZLWK,86 UHVSHFWLYHO\ S )DOVHQHJDWLYHUHVXOWVZHUHGHWHFWHGLQDQG RISDWLHQWVZLWKRXWDQGZLWK,86 S 87,ZDVGHWHFWHGLQDQG RISDWLHQWVZLWKRXWDQGZLWK7&&UHVSHFWLYHO\+RZHYHURIWKHSDWLHQWVZLWK 87,SUHVHQWHGZLWK7&& PXVFOHLQYDVLYHGLVHDVHVXSHUᚏFLDO7&& DQG&,6 )RUWKH8UR9\VLRQWHVW Q IDOVHSRVLWLYHUHVXOWVRFFXUUHG LQ LQERWKJURXSVUHJDUGOHVVRI87, S )DOVHQHJDWLYHUHVXOWVZHUH GHWHFWHG LQ DQG RI SDWLHQWV ZLWKRXW DQG ZLWK 87, S )RU WKHX&\WWHVW Q IDOVHSRVLWLYHUHVXOWVZHUHQRWHGLQDQGRI SDWLHQWVZLWKRXWDQGZLWK87,UHVSHFWLYHO\ S )DOVHQHJDWLYHUHVXOWVZHUH IRXQGLQDQGRISDWLHQWVZLWKRXWDQGZLWK87, S &RQYHUVHO\ WKHUH ZDV D VLJQLᚏFDQW GLᚎHUHQFH S UHJDUGLQJ IDOVH SRVLWLYLW\ RI XULQDU\ F\WRORJ\ Q IDOVHSRVLWLYHUHVXOWVZHUHUHFRUGHGLQZLWKRXW87,ZKLOH ZLWK87,GLVSOD\HGDSRVLWLYHF\WRORJ\)DOVHQHJDWLYHUHVXOWVZHUHDOPRVW LGHQWLFDOLQYVRISDWLHQWVZLWKRXWDQGZLWK87, S Conclusions: 7KH SUHVHQFH RI 87, LV FOHDUO\ LQᚐXHQFLQJ WKH VSHFLᚏFLW\ RI XULQH F\WRORJ\,QᚐDPPDWRU\FHOOVPD\EHPLVLQWHUSUHWHGDVPDOLJQDQWXURWKHOLDOFHOOV 87,GRHVQRWLQWHUIHUHZLWKHLWKHUWKH8UR9\VLRQWHVWRUWKHX&\WWHVW87,GRHV QRWDFWLYDWHWKHPROHFXODUIHDWXUHVGHWHFWHGE\WKH8UR9\VLRQDQGWKHX&\WWHVWV OHDGLQJWRWKHVXVSLFLRQIRU7&&,86LQᚐXHQFHVWKHVSHFLᚏ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
54
IS URINE CYTOLOGY A RELEVANT INVESTIGATION FOR UROLOGICAL MALIGNANCIES?
0LVKULNL6)0RORNZX&16ZHHQH\&/DP7-DQMXD.6 Aberdeen Royal Infirmary, Dept. of Urology, Aberdeen, United Kingdom Introduction & Objectives: 0RVWFXUUHQWJXLGHOLQHVIRUDV\PSWRPDWLFKDHPDWXULD LQYHVWLJDWLRQUHFRPPHQGPDQGDWRU\XULQHF\WRORJ\+RZHYHUZLWKDORZVHQVLWLYLW\ HVSHFLDOO\IRUORZJUDGHWXPRXUVWKHHYLGHQFHIRULWVFRQWLQXHGXVHLVZHDN9DOLGLW\ DQGFRVWHᚎHFWLYHQHVVRIXULQHF\WRORJ\LVQRWSURYHQ3UHYLRXVVWXG\KDVVKRZQ WKDWF\VWRVFRS\FRXOGQRWEHVDIHO\RPLWWHG7KHDLPRIWKLVVWXG\LVWRJDXJHWKH YDOXHRIXULQHF\WRORJ\DVURXWLQHLQYHVWLJDWLRQIRUKDHPDWXULD Material & Methods: FRQVHFXWLYHSDWLHQWVZHUHSURVSHFWLYHO\VWXGLHGIURP -DQXDU\ WRGDWH'DWDVHWLQFOXGHVDJHVH[VPRNLQJIUDQNKDHPDWXULD )+ RUGLSVWLFNKDHPDWXULD '+ SDWLHQWVSUHVHQWHGZLWKIUDQNKDHPDWXULDDQG SUHVHQWHG ZLWK GLSVWLFN KDHPDWXULD 3DWLHQWV XQGHUZHQW XOWUDVRXQG VFDQ RI WKHUHQDOWUDFWDQGᚐH[LEOHF\VWRVFRS\8ULQHF\WRORJ\ZDVURXWLQHO\VXEPLWWHG,98 ZDV DUUDQJHG ODWHU WR FRPSOHWH WKH LQYHVWLJDWLRQV IRU SDWLHQWV ZLWK XQGLDJQRVHG )+ Results: 7KHPDOHWRIHPDOHUDWLRZDVRYHU ZLWKRISDWLHQWVSUHVHQWLQJ ZLWK)+,UUHVSHFWLYHRIDJH RI)+DQG RI'+SDWLHQWVZHUH GLDJQRVHG ZLWK XURORJLFDO PDOLJQDQF\ 7KHUH ZHUH QR XURORJLFDO PDOLJQDQFLHV LGHQWLᚏHGLQSDWLHQWVZLWK'+XQGHU\HDUV7KHVHQVLWLYLW\DQGVSHFLᚏFLW\RIXULQH F\WRORJ\ZHUHDQG UHVSHFWLYHO\8ULQHF\WRORJ\GHWHFWHGRQHSULPDU\ FDUFLQRPDLQVLWXRIWKHEODGGHULQZKLFKWKHF\VWRVFRS\ZDVLQFRUUHFWO\UHSRUWHG DV QRUPDO 7KH REVHUYHG ᚏQGLQJ RI ಫPLOGಬ PXFRVDO HU\WKHPD DORQH VKRXOG KDYH QHFHVVLWDWHGEODGGHUELRSVLHVLUUHVSHFWLYHRIXULQHF\WRORJ\UHVXOWV8ULQHF\WRORJ\ ZDVQHJDWLYHLQRQHFDVHRIUHQDO7&& 'LDJQRVLV %ODGGHUFDQFHU 5HQDOFDQFHU 5HQDO7&& 8URWKHOLDOPHODQRPD
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Conclusions: 8ULQHF\WRORJ\GHWHFWHGRQHSULPDU\&,6RXWRIEODGGHUWXPRXUV 7KLVSURVSHFWLYHDQDO\VLVVKRZVWKDWRPLWWLQJXULQHF\WRORJ\LVQRWGHWULPHQWDOLQ LQYHVWLJDWLQJ SDWLHQWV ZLWK KDHPDWXULD &RQWLQXHG URXWLQH XVH RI F\WRORJ\ LQ WKH KDHPDWXULDFOLQLFFDQQRWEHVXSSRUWHGE\FXUUHQWHYLGHQFH
COMPARISON OF MOLECULAR MARKERS, SUB-STAGE AND THE EORTC RISK-SCORE TO PREDICT CLINICAL OUTCOME OF PT1 BLADDER CANCER
9DQ5KLMQ%:*9DQ'HU.ZDVW7+%DSDW%%RVWURP3- )OHVKQHU1(9DQ'HU$D010/LX/%DQJPD&+-HZHWW0$6 =ZDUWKRᚎ(&=ORWWD$5 1 University Health Network, Dept. of Surgical Oncology (Urology), Toronto, Canada, 2University Health Network, Dept. of Pathology, Toronto, Canada, 3 Mount Sinai Hospital, Dept. of Cancer Genetics, Toronto, Canada, 4Erasmus Medical Centre, Dept. of Urology, Rotterdam, The Netherlands, 5Erasmus Medical Centre, Dept. of Pathology, Rotterdam, The Netherlands Introduction & Objectives: :H HYDOXDWHG WKH LPSDFW RI VXEVWDJH FOLQLFR SDWKRORJLFDO SDUDPHWHUV DQG PROHFXODU PDUNHUV RQ WKH FOLQLFDO RXWFRPH RI SULPDU\S7EODGGHUFDQFHU %& WUHDWHGZLWK%&* Material & Methods: 7KH VOLGHV RI SULPDU\ %& IURP 5RWWHUGDP 1/ Q DQG7RURQWR&DQDGD Q ZHUHUHYLHZHGDQGWKHS7GLDJQRVLVZDVFRQᚏUPHG 6XEVWDJLQJZDVGRQHLQWZRVHSDUDWHURXQGVXVLQJDQHZV\VWHPLHS7PLFUR LQYDVLYH S7P DQGS7H[WHQVLYHLQYDVLYH S7H >@DQGDFFRUGLQJWRLQYDVLRQ RIWKHPXVFXODULVPXFRVDH S7DS7ES7F 8QLDQGPXOWLYDULDWHDQDO\VHVIRU UHFXUUHQFHDQGSURJUHVVLRQZHUHSHUIRUPHGZLWKFOLQLFDO VL]HPXOWLSOLFLW\KRVSLWDO JHQGHU DJH SDWKRORJLFDO VXEVWDJH &,6 JUDGH DQG PROHFXODU PDUNHUV )*)5 PXWDWLRQ DQG 0,% 3 3 H[SUHVVLRQ 7KH (257& ULVN VFRUHVIRUUHFXUUHQFHDQGSURJUHVVLRQZHUHFDOFXODWHG>@ Results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ᚏFDQWLQXQLYDULDWH DQDO\VLVIRUUHFXUUHQFHZHUHPXOWLSOLFLW\ 3 DQG&,6 3 ,QPXOWLYDULDWH DQDO\VLVIRUUHFXUUHQFHPXOWLSOLFLW\ 3 55 &, ZDVWKHRQO\ VLJQLᚏFDQWYDULDEOH6LJQLᚏFDQWLQXQLYDULDWHDQDO\VLVIRUSURJUHVVLRQZHUHJHQGHU 3 VXEVWDJH PH 3 VXEVWDJH DEF 3 &,6 3 )*)5 3 0,% 3 3 3 0,%3 3 )*)5 0,% 3 DQG)*)53 3 ,QPXOWLYDULDWHDQDO\VLVIRUSURJUHVVLRQ IHPDOH JHQGHU 3 55 &, VXEVWDJH PH 3 55 &, DQG&,6 3 55 &, ZHUHWKHVLJQLᚏFDQW YDULDEOHV*UDGHDQGWKH(257&ULVNVFRUHVZHUHQHYHUVLJQLᚏFDQW Conclusions: 0XOWLSOLFLW\ ZDV WKH VWURQJHVW SUHGLFWRU RI UHFXUUHQFH ZKLOH &,6 IHPDOHJHQGHUDQGVXEVWDJH S7PS7H >@ZHUHWKHPRVWLPSRUWDQWYDULDEOHV IRUSURJUHVVLRQLQS7%&7KHDGGLWLRQDOYDOXHRIPROHFXODUPDUNHUVZDVPRGHVW 7KH YDOXH RI WKH (257& ULVNVFRUH ZDV OLPLWHG LQ WKLV SULPDU\ S7%& JURXS 5HIHUHQFHV 9DQGHU$DHWDO+XP3DWKRO %DEMXNHWDO(XU 8URO
53
IMPACT OF URINARY SAMPLING AND URINARY TRACT INFECTION ON THE DIAGNOSTIC VALUE OF URINE TESTS (UROVYSIONR, UCYT+R) AND CYTOLOGY FOR TRANSITIONAL CELL CARCINOMA – RESULTS FROM A COHORT OF 2077 PATIENTS
6FKZHQWQHU&+HQQHQORWWHU-.XHKV87HZV9&ROOHVHOOL'+XEHU6 6FKLOOLQJ'6LHYHUW.'6WHQ]O$ Eberhard-Karls University Tübingen, Dept. of Urology, Tübingen, Germany Introduction & Objectives: %HVLGH XULQH F\WRORJ\ WKH 8UR9\VLRQ5 9\VLV DQG X&\W5 'LDJQRFXUH WHVWVV\VWHPVDUHXVHGIRUWKHHDUO\GHWHFWLRQRIWUDQVLWLRQDO FHOO FDUFLQRPD 7&& :KHUHDV LQVWUXPHQWHG XULQDU\ VDPSOLQJ ,86 LV DQ H[FOXVLRQFULWHULRQIRUVHYHUDORWKHU7&&WHVWNLWVWKHUHDUHQRH[DFWVSHFLᚏFDWLRQV IRU WKH 8UR9\VLRQ DQG X&\W V\VWHPV &RQFRPLWDQW XULQDU\ WUDFW LQIHFWLRQ 87, PD\ DOVR KDYH DQ LPSDFW RQ WKH WHVW ᚏQGLQJV *LYHQ WKH ODFN RI GDWD WKHUH DUH QR UHFRPPHQGDWLRQV DYDLODEOH LI XULQDU\ WUDFW PDQLSXODWLRQ LQWHUIHUHV ZLWK WKH DIRUHPHQWLRQHG WHVWV +HUHLQ ZH HYDOXDWH WKH LPSDFW RI ,86 DQG 87, RQ XULQH F\WRORJ\WKH8UR9\VLRQ),6+WHVW 9\VLV5 DQGWKHX&\WWHVW Material & Methods: $ FRKRUW RI FRQVHFXWLYH SDWLHQWV VXVSHFWHG WR KDYH 7&& XQGHUZHQW WKH PXOWLPDUNHU WHVWLQJ RI WKH PHQWLRQHG WHVWV IROORZHG E\ F\VWRVFRS\DQGLQFDVHRIVXVSLFLRXVᚏQGLQJVWUDQVXUHWKUDOUHVHFWLRQ$OOSDWLHQWV ZHUHLQYHVWLJDWHGUHJDUGLQJWKHWHFKQLTXHRIXULQDU\VSHFLPHQKDUYHVWLQJ,86ZDV GHᚏQHGDVFDWKHWHUL]HGLUULJDWHGRUH[SULPDWHGXULQHZKHUHDVVSRQWDQHRXVYRLGLQJ ZDV GHᚏQHG DV XULQH FROOHFWHG ZLWKRXW ,86 87, ZDV GHWHUPLQHG E\ &RPEXU HYDOXDWLRQDQGXULQHPLFURVFRS\$FRQVWHOODWLRQRIุOHXFRF\WHVVLPXOWDQHRXV KHPDWXULDRUQLWULWHSRVLWLYLW\DVZHOODVVLJQLᚏFDQWEDFWHULXULDZHUHGHᚏQHGDV87, 7KHWHVWUHVXOWVZHUHFRPSDUHGZLWKUHJDUGVWRWKHLQYDVLYHQHVVRIXULQHFROOHFWLRQ DQG87,VWDWXVE\FRQWLQJHQF\DQDO\VLVDQG&KLVTXDUHWHVWVVHSDUDWHO\IRUSDWLHQWV ZLWKRXWHYLGHQFHRI7&&DQGZLWKKLVWRORJLFDOO\SURYHQ7&&
Eur Urol Suppl 2010;9(2):50
Results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ᚏFLDO7&& DQG&,6 )RUWKH8UR9\VLRQWHVW Q IDOVHSRVLWLYHUHVXOWVRFFXUUHG LQ LQERWKJURXSVUHJDUGOHVVRI87, S )DOVHQHJDWLYHUHVXOWVZHUH GHWHFWHG LQ DQG RI SDWLHQWV ZLWKRXW DQG ZLWK 87, S )RU WKHX&\WWHVW Q IDOVHSRVLWLYHUHVXOWVZHUHQRWHGLQDQGRI SDWLHQWVZLWKRXWDQGZLWK87,UHVSHFWLYHO\ S )DOVHQHJDWLYHUHVXOWVZHUH IRXQGLQDQGRISDWLHQWVZLWKRXWDQGZLWK87, S &RQYHUVHO\ WKHUH ZDV D VLJQLᚏFDQW GLᚎHUHQFH S UHJDUGLQJ IDOVH SRVLWLYLW\ RI XULQDU\ F\WRORJ\ Q IDOVHSRVLWLYHUHVXOWVZHUHUHFRUGHGLQZLWKRXW87,ZKLOH ZLWK87,GLVSOD\HGDSRVLWLYHF\WRORJ\)DOVHQHJDWLYHUHVXOWVZHUHDOPRVW LGHQWLFDOLQYVRISDWLHQWVZLWKRXWDQGZLWK87, S Conclusions: 7KH SUHVHQFH RI 87, LV FOHDUO\ LQᚐXHQFLQJ WKH VSHFLᚏFLW\ RI XULQH F\WRORJ\,QᚐDPPDWRU\FHOOVPD\EHPLVLQWHUSUHWHGDVPDOLJQDQWXURWKHOLDOFHOOV 87,GRHVQRWLQWHUIHUHZLWKHLWKHUWKH8UR9\VLRQWHVWRUWKHX&\WWHVW87,GRHV QRWDFWLYDWHWKHPROHFXODUIHDWXUHVGHWHFWHGE\WKH8UR9\VLRQDQGWKHX&\WWHVWV OHDGLQJWRWKHVXVSLFLRQIRU7&&,86LQᚐXHQFHVWKHVSHFLᚏ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
54
IS URINE CYTOLOGY A RELEVANT INVESTIGATION FOR UROLOGICAL MALIGNANCIES?
0LVKULNL6)0RORNZX&16ZHHQH\&/DP7-DQMXD.6 Aberdeen Royal Infirmary, Dept. of Urology, Aberdeen, United Kingdom Introduction & Objectives: 0RVWFXUUHQWJXLGHOLQHVIRUDV\PSWRPDWLFKDHPDWXULD LQYHVWLJDWLRQUHFRPPHQGPDQGDWRU\XULQHF\WRORJ\+RZHYHUZLWKDORZVHQVLWLYLW\ HVSHFLDOO\IRUORZJUDGHWXPRXUVWKHHYLGHQFHIRULWVFRQWLQXHGXVHLVZHDN9DOLGLW\ DQGFRVWHᚎHFWLYHQHVVRIXULQHF\WRORJ\LVQRWSURYHQ3UHYLRXVVWXG\KDVVKRZQ WKDWF\VWRVFRS\FRXOGQRWEHVDIHO\RPLWWHG7KHDLPRIWKLVVWXG\LVWRJDXJHWKH YDOXHRIXULQHF\WRORJ\DVURXWLQHLQYHVWLJDWLRQIRUKDHPDWXULD Material & Methods: FRQVHFXWLYHSDWLHQWVZHUHSURVSHFWLYHO\VWXGLHGIURP -DQXDU\ WRGDWH'DWDVHWLQFOXGHVDJHVH[VPRNLQJIUDQNKDHPDWXULD )+ RUGLSVWLFNKDHPDWXULD '+ SDWLHQWVSUHVHQWHGZLWKIUDQNKDHPDWXULDDQG SUHVHQWHG ZLWK GLSVWLFN KDHPDWXULD 3DWLHQWV XQGHUZHQW XOWUDVRXQG VFDQ RI WKHUHQDOWUDFWDQGᚐH[LEOHF\VWRVFRS\8ULQHF\WRORJ\ZDVURXWLQHO\VXEPLWWHG,98 ZDV DUUDQJHG ODWHU WR FRPSOHWH WKH LQYHVWLJDWLRQV IRU SDWLHQWV ZLWK XQGLDJQRVHG )+ Results: 7KHPDOHWRIHPDOHUDWLRZDVRYHU ZLWKRISDWLHQWVSUHVHQWLQJ ZLWK)+,UUHVSHFWLYHRIDJH RI)+DQG RI'+SDWLHQWVZHUH GLDJQRVHG ZLWK XURORJLFDO PDOLJQDQF\ 7KHUH ZHUH QR XURORJLFDO PDOLJQDQFLHV LGHQWLᚏHGLQSDWLHQWVZLWK'+XQGHU\HDUV7KHVHQVLWLYLW\DQGVSHFLᚏFLW\RIXULQH F\WRORJ\ZHUHDQG UHVSHFWLYHO\8ULQHF\WRORJ\GHWHFWHGRQHSULPDU\ FDUFLQRPDLQVLWXRIWKHEODGGHULQZKLFKWKHF\VWRVFRS\ZDVLQFRUUHFWO\UHSRUWHG DV QRUPDO 7KH REVHUYHG ᚏQGLQJ RI ಫPLOGಬ PXFRVDO HU\WKHPD DORQH VKRXOG KDYH QHFHVVLWDWHGEODGGHUELRSVLHVLUUHVSHFWLYHRIXULQHF\WRORJ\UHVXOWV8ULQHF\WRORJ\ ZDVQHJDWLYHLQRQHFDVHRIUHQDO7&& 'LDJQRVLV %ODGGHUFDQFHU 5HQDOFDQFHU 5HQDO7&& 8URWKHOLDOPHODQRPD
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Conclusions: 8ULQHF\WRORJ\GHWHFWHGRQHSULPDU\&,6RXWRIEODGGHUWXPRXUV 7KLVSURVSHFWLYHDQDO\VLVVKRZVWKDWRPLWWLQJXULQHF\WRORJ\LVQRWGHWULPHQWDOLQ LQYHVWLJDWLQJ SDWLHQWV ZLWK KDHPDWXULD &RQWLQXHG URXWLQH XVH RI F\WRORJ\ LQ WKH KDHPDWXULDFOLQLFFDQQRWEHVXSSRUWHGE\FXUUHQWHYLGHQFH