Eyyüp Sabri Pelit

The value of the NMP22 test for superficial bladder cancer diagnosis and follow-up

OBJECTIVE In this study, we investigated the efficacy of nuclear matrix protein 22 (NMP22) in the diagnosis and surveillance of bladder cancer. MATERIAL AND METHODS Patients with hematuria or who applied for cystoscopic control of proven bladder cancer were prospectively enrolled in this study. Routine cytologic examination and NMP22 test were performed on the voided urine sample obtained before the cystoscopy. The patients who had been diagnosed with bladder cancer were categorized according to stage, grade, number, size of the tumor and risk of the disease. Then the diagnostic performance of the NMP22 and the cytology test, alone or in combination, were evaluated separately using ROC curves in the diagnosis and surveillance groups. RESULTS A total of 87 patients (87/136) were investigated because of hematuria. The sensitivity, specificity, positive and, negative predictive values, and positive likelihood ratio (LR+) of the NMP22 test were 70, 80, 68, 81, and 3.42%, respectively. While, the sensitivity, specificity, positive and, negative predictive values, and positive likelihood ratio (LR+) of the cytology examination were 27, 96, 82, 68, and 7.36%, respectively. There were 49 patients in the bladder cancer group. The sensitivity, specificity, positive, and negative predictive values and positive likelihood ratio (LR+) of the NMP22 test in these patients were 33, 76, 31, 78 and 1.37%, respectively. The sensitivity, specificity, positive and, negative predictive values, and positive likelihood ratio (LR+) of the cytology examination were 25%, 97%, 75%, 80% and 9.25, respectively. CONCLUSION NMP22 test can be used as an adjunctive tool for the detection of bladder cancer, but its diagnostic performance is limited in surveillance when used alone or in combination with a cytology examination.

Testis-sparing surgery of unilateral testicular large-cell calcifying Sertoli cell tumor: a sporadic case

Testicular sex cord-stromal tumors constitute a small portion of all types of testicular tumors. Only 1% of these tumors are pure Sertoli cell tumors. Sertoli cell tumors have three identified subgroups: large-cell calcifying (LCCSCT), sclerosing Sertoli cell and general type. Up to 40% of LCCSCT are associated with the genetic syndromes like Carney complex, Peutz-Jeghers syndrome. These lesions are usually benign, only 17% of the cases show malignant behaviour. Herein, we report a case of unilateral LCCSCT in a 37 year-old man without any hormonal symptoms or inherited diseases which was succesfully treated with testis-sparing surgery.

A Rare Cause of Maternal Hydronephrosis: Y-Type Partial Duplicated Ureter

Gestational hydronephrosis is observed in 80-90% of the pregnancy due to the dilatation effect of progesterone hormone and the secondary to mechanical compression of the uterus1. The common causes of the maternal hydronephrosis can be listed as physiological hydroureteronephrosis of the pregnancy, urolithiasis and genitourinary system anomalies2. Ureteral duplication is a common anomaly, observed in approximately 1 in 125 people on autopsy series3. Duplicated systems have 2 complete ureters with separate insertions into the lower urinary tract in 40% of the patients. The others have a partially duplicated system named as Y configuration4. To our best knowledge, it is a very rare case presentation in the current literature about the maternal hydronephrosis which is caused by bifid Y-type ureter.