Background Transitional cell carcinoma of the upper urinary tract(UUT-TCC)accounts for 5% to 10% of all renaltumours and 5% to 6% of all urothelial tumours all over the world.In China,the proportion of UUT-TCC to all urothelialturnouts may be 26%,which is higher than that in the western world.The early diagnosis of UUT-TCC is difficult and thepresent study elucidates the diagnostic value of poor or nonvisualization(PNV)in intravenous urography in patients withUUT-TCC and its correlations with pathological findings and clinical characteristics.Methods The data of 172 consecutive patients between January 1997 and January 2005 with UUT-TCC whounderwent nephroureterectomy in our departments were selected and analyzed retrospectively.Results Of our sample,144 cases presented with gross haematuria(83.7%)and 12 with microscopic haematuria(7.0%).Forty-six cases(26.7%)were detectable by cytology.Filling defect identified 36 positive cases of 172 patients(20.9%),PNV was present in the images of 105 of 172 patients(61.0%).The detection rate by PNV(61.0%)wassignificantly different from that by cytology(26.7%)or by filling defect(20.9%)(P=0.031,P=0.001,respectively).Univariate logistic regression analysis for PNV showed that tumour stage,grade and size were significant predictors(P=0.028;P=0.031;P=0.006,respectively).Tumour stage and size were identified as independent risk factors in themultivariate logistic regression model(P=0.042;P=0.014).Conclusions Except for suspected urolithiasis,urinary tuberculosis or congenital abnormalities,UUT-TCC should beconsidered if PNV exists in intravenous urography especially of old patients.The value of PNV is much more significantthan filling defect in intravenous urography in the diagnosis of UUT-TCC.It is supposed that PNV carries more risk ofhigher stage and larger tumour size in UTT-TCC.Chin Med J 2007;120(16):1387-1390 Background Transitional cell carcinoma of the upper urinary tract (UUT-TCC) accounts for 5% to 10% of all renal tumors and 5% to 6% of all urothelial tumors all over the world. China, the proportion of UUT-TCC to all urothelialturnouts may be 26%, which is higher than that in the western world. The early diagnosis of UUT-TCC is difficult and the present study elucidates the diagnostic value of poor or nonvisualization (PNV) in intravenous urography in patients withUT-TCC and its correlations with pathological findings and clinical characteristics. Methods The data of 172 consecutive patients between January 1997 and January 2005 with UUT-TCC whounderwent nephroureterectomy in our departments were selected and analyzed retrospectively. Results of our sample, 144 cases presented with gross haematuria (83.7%) and 12 with microscopic haematuria (7.0%). Forty-six cases (26.7%) were detectable by cytology. Filling defect identified 36 positive cases of 172 patients (20.9%), PNV was present in the images of The detection rate by PNV (61.0%) wassignificantly different from that by cytology (26.7%) or by filling defect (20.9%) (P = 0.031, P = 0.001, respectively) .Univariate logistic regression analysis for PNV showed that tumor stage, grade and size were significant predictors (P = 0.028; P = 0.006, respectively) .Tumor stage and size were identified as independent risk factors in the patients with variable logistic regression model (P = 0.042 ; P = 0.014) .Conclusions Except for suspected urolithiasis, urinary tuberculosis or congenital abnormalities, UUT-TCC should beconsidered if PNV exists in intravenous urography especially of old patients. The value of PNV is much more significant dysfunction in intravenous urography in the diagnosis of UUT-TCC.It is that that PNV carries more risk ofhigher stage and larger size size in UTT-TCC. Chin Med J 2007; 120 (16): 1387-1390