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Upper Urinary Tract Urothelial Cancer
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==== <span style="color:#ff0000">Universal histologic testing of UTUC with additional studies, such as immunohistochemical (IHC) or microsatellite instability (MSI)</span> ==== *'''Routine tissue testing provides a more sensitive, first-line means to identify Lynch syndrome-associated features in tumor samples[https://pubmed.ncbi.nlm.nih.gov/37096584/]''' **Immunohistochemical testing *** Can preliminarily identify the altered proteins associated with Lynch syndrome, and thus help to identify patients who may have the syndrome, who then require confirmation with further genetic (germline) testing ***Widely available **Microsatellite instability ***Identifying the presence of Lynch syndrome-associated and MSI-high cancers also has clinical implications related to therapeutic treatment options, including identified sensitivity of urothelial cancers with mutations in DNA damage repair genes to systemic agents such as immune checkpoint inhibitors and cisplatinum-based chemotherapy
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