title: [Clinical, ureteroscopic and photodynamic diagnosis of urothelial carcinomas of the upper tract: state-of-the art review for the yearly scientific report of the French National Association of Urology].
abstract: OBJECTIVE
  To propose a state-of-the art of current knowledge about clinical, ureteroscopic and photodynamic for the diagnosis of the upper urinary tract cancer (UTUC).
  
  
  METHODS
  A systematic review of the literature search was performed from the database Medline (NLM, Pubmed), focused on the following keywords: urothelial carcinomas; upper urinary tract; ureter; renal pelvis; diagnosis; fluorescence; ureteroscopy; photodynamic technique; biopsy; cytology.
  
  
  RESULTS
  Gross hematuria and flank pain are the two main clinical symptoms revealing a UTUC in daily clinical practice. Urinary cystoscopy and cystoscopy are mandatory to rule out a concomittant synchronous bladder tumour. Flexible ureteroscopy has revolutionized the management of UTUC by allowing a full exploration of upper urinary tract, an endoscopi vizualization of the tumour and assessment of grade with biopsies. A flexible ureteroscopy is mandatory in diagnostic evaluation of UTUC as soon as a conservative management is being considered. New investigation technologies such as fluorescence, narrow band imaging and optical coherence tomography (± combined with ultra sound), are promising for a near future.
  
  
  CONCLUSIONS
  It has to be understood that the diagnostic work-up of a UTUC has to be exhaustive and particularly the search of another urothelial carcinoma within the urinary tract. Flexible ureterosocopy has revolutionized the diagnosis and management of UTUC and belongs fully to its initial evaluation.
authors.affiliation: Service d'urologie, hôpital Claude-Huriez, université de Lille, CHRU Lille, 59000 Lille, France.
authors.forename: L
authors.initials: L
authors.lastname: Nison
authors.affiliation: Service d'urologie, hôpital Claude-Huriez, université de Lille, CHRU Lille, 59000 Lille, France.
authors.forename: G
authors.initials: G
authors.lastname: Bozzini
authors.affiliation: Service d'urologie, hôpital Pitié-Salpêtrière, faculté de médecine Pierre-et-Marie-Curie, université Paris 6, 83, boulevard Hôpital, AP-HP, 75013 Paris, France. Electronic address: morgan.roupret@psl.aphp.fr.
authors.forename: M
authors.initials: M
authors.lastname: Rouprêt
authors.affiliation: Service d'urologie, hôpital Tenon, AP-HP, université Pierre-et-Marie-Curie, université Paris 6, 75020 Paris, France.
authors.forename: O
authors.initials: O
authors.lastname: Traxer
authors.affiliation: Service d'urologie, hôpital Privé-de-La-Louvière, Générale-de-Santé, 59037 Lille, France; Service d'urologie, hôpital de Seclin, 59113 Seclin, France.
authors.forename: P
authors.initials: P
authors.lastname: Colin
mesh_terms: D001706:Biopsy; D002295:Carcinoma, Transitional Cell / Q000175:diagnosis*; D021501:Flank Pain / Q000209:etiology; D006417:Hematuria / Q000209:etiology; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D062048:Narrow Band Imaging; D061848:Optical Imaging; D041623:Tomography, Optical Coherence; D018666:Ureteroscopy; D014556:Urine / Q000166:cytology; D014567:Urography; D014571:Urologic Neoplasms / Q000175:diagnosis*; D019459:Urothelium / Q000473:pathology*
keywords: (MeSH); Bassinet; Biopsie; Biopsy; Carcinome urothélial; Cytologie; Cytology; Diagnosis; Diagnostic; Fluorescence; Photodynamic technique; Renal pelvis; Technique photodynamique; Upper urinary tract; Ureter; Ureteroscopy; Uretère; Urothelial carcinomas; Urétéroscopie; Voie excrétrice urinaire