Objectives. To assess the performance of urine markers determined in urine samples from the bladder compared to samples\ncollected from the upper urinary tract (UUT) for diagnosis of UUT urothelial carcinoma (UC). Patients and Methods. The study\ncomprised 758 urine samples either collected from the bladder (n = 373) or UUT (n = 385). All patients underwent\nurethrocystoscopy and UUT imaging or ureterorenoscopy. Cytology, fluorescence in situ hybridization (FISH), immunocytology\n(uCyt+), and nuclear matrix protein 22 (NMP22) were performed. Results. UUT UC was diagnosed in 59 patients (19.1%)\n(UUT urine) and 27 patients (7.2%) (bladder-derived urine). For UUT-derived samples, sensitivities for cytology, FISH,\nNMP22, and uCyt+ were 74.6, 79.0, 100.0, and 100.0, while specificities were 66.6, 50.7, 5.9, and 66.7%, respectively. In\nbladder-derived samples, sensitivities were 59.3, 52.9, 62.5, and 50.0% whereas specificities were 82.9, 85.0, 31.3, and 69.8%.\nIn UUT-derived samples, concomitant bladder cancer led to increased false-positive rates of cytology and FISH. Conclusions.\nUrine markers determined in urine collected from the UUT exhibit better sensitivity but lower specificity compared to markers\ndetermined in bladder-derived urine. Concomitant or recent diagnosis of UC of the bladder can further influence markers\ndetermined in UUT urine.
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