Atypical cytology Cxbladder Cytology Diagnosis Equivocal cystoscopy Urothelial carcinoma
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摘要

BACKGROUND:Cxbladder diagnostic tests combine genomic information from urinary mRNA with phenotypic information to either rule out low-risk individuals or identify patients at a high risk of urothelial carcinoma (UC).
OBJECTIVE:To evaluate the performance of Cxbladder and urine cytology, and Cxbladder's adjudication of atypical cytology and equivocal cystoscopy.
DESIGN, SETTING, AND PARTICIPANTS:This is a retrospective analysis of pooled data from three prospective Cxbladder clinical trials and one real-world clinical study. Physicians were blinded to Cxbladder results, and Cxbladder providers were blinded to clinical results. This study analyzed diverse urology practices in the USA, Australia, and New Zealand. A total of 1784 consecutive, prospectively recruited patients with hematuria or previously diagnosed UC provided 852 samples with both local cytology and Cxbladder results; 153 had atypical cytologies and 14 had both atypical cytology and equivocal cystoscopy.
OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS:Negative predictive value (NPV) and proportion of tumors missed for Cxbladder and local cytology, and evaluation of Cxbladder for adjudicating atypical cytology and equivocal cystoscopy.
RESULTS AND LIMITATIONS:Cxbladder ruled out 35% of patients and NPV 97% (95% confidence interval [CI] 94-98%) compared with 93% (95% CI 91-94%) for cytology; Cxbladder missed 8.5% and cytology missed 63% of tumors. UC was diagnosed in 26/153 cases of atypical cytology (17%). Cxbladder correctly adjudicated all these patients including those with both atypical cytology and equivocal cystoscopy; these patients had a positive Cxbladder result and were diagnosed with UC by pathology. The incidence of patients with both atypical cytology and equivocal cystoscopy is low.
CONCLUSIONS:Cxbladder correctly adjudicated all patients diagnosed with UC among those with atypical cytology and equivocal cystoscopy, and outperformed cytology for accurately identifying patients who do not have UC.
PATIENT SUMMARY:Cxbladder accurately rules out patients who do not have cancer, and adjudicates cytology and cystoscopy with inconclusive results, minimizing the need for patients to undergo further unnecessary tests and procedures.

译文

背景: cx膀胱诊断测试将尿液 mRNA 的基因组信息与表型信息相结合,以排除低风险个体或识别尿路上皮癌 (UC) 的高风险患者。
目的: 评价膀胱和尿液细胞检查的性能,以及不典型细胞检查和可疑膀胱镜检查对膀胱的诊断。
设计、设置和参与者: 这是对来自三个前瞻性 cx膀胱临床试验和一个真实世界临床研究的汇总数据的回顾性分析。医生对 cx膀胱结果视而不见,cx膀胱提供者对临床结果视而不见。本研究分析了美国、澳大利亚和新西兰不同的泌尿外科实践。总共 1784 个连续的、前瞻性招募的血尿或先前诊断为 UC 的患者提供了 852 个样本,其中包括局部细胞和 cx膀胱结果; 153 个样本具有非典型细胞,14 个样本具有非典型细胞和可疑的膀胱镜检查。
结果测量和统计分析: 阴性预测值 (NPV) 和 cx膀胱和局部细胞学漏诊肿瘤的比例,以及评估 cx膀胱用于判定非典型细胞学和可疑膀胱镜检查。
结果和局限性: cx膀胱排除了 35% 的患者和 NPV 97% (95% 置信区间 [CI] 94-98%),而细胞学排除了 93% (95% CI 91-94%); cx膀胱漏诊 8.5%,肿瘤细胞漏诊 63%。在 26/153 例非典型细胞检查中诊断为 UC (17%)。Cxblue 正确判定了所有这些患者,包括那些具有非典型细胞学和可疑膀胱镜检查的患者; 这些患者 cxblue 结果阳性,并通过病理诊断为 UC。不典型细胞检查和可疑膀胱镜检查的患者发病率低。
结论: 在那些不典型的细胞学和模棱两可的膀胱镜检查中,cxblue 正确判断了所有被诊断为 UC 的患者,并且在准确识别没有 UC 的患者方面优于细胞学检查。
患者总结: cxblacy 准确地排除了没有癌症的患者,并判定了细胞检查和膀胱镜检查结果不确定,最大限度地减少了患者接受进一步不必要的检查和程序的需要。

Cystoscopy

肾内泌尿 膀胱 诊断方式
概述  :  

疾病概述膀胱镜检查(Cystoscopy)是经尿道进入膀胱的一种内窥镜检查方法,临床上常用于诊断膀胱、肾脏、输尿管及尿道的疾病,以了解血尿的来源及泌尿系邻近器官病变。它是泌尿外科常用的检查及治疗手段。 适应症1.用于诊断 通过检查窥镜可以观察到膀胱内情况;通过输尿管插管窥镜,可向输尿管插入细长的输尿管导管至肾盂,分别搜集尿液,进行常规检查和培养;静脉注入靛胭脂溶液,观察两侧输尿管的排蓝时间,可以分别估计两侧肾功能(正常注药后5~10分钟排蓝);经导管向肾盂或输尿管注入12.5%碘化钠造

Cystoscopy   / sɪs'tɒskəpɪ /

释    义   n. [泌尿] 膀胱镜检查

同根词   chronically adv. 长期地;慢性地;习惯性地

例    句   To explore the significance of nursing care in cystoscopy. 探讨护理干预在膀胱镜检查中的作用。

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