Diagnostic Value of Fluorescence in Situ Hybridization Assay in Malignant Mesothelioma: A Meta-analysis

Abstract

The diagnosis of malignant mesothelioma (MM) remains a clinical challenge and the fluorescence in situ hybridization (FISH) assay has been reported to be one promising tool. The present meta-analysis aimed to establish the overall diagnostic accuracy of FISH for diagnosing MM. After a systematic review of English language studies, the sensitivity, specificity and other measures of accuracy of FISH in the diagnosis of MM were pooled using random-effects models. Summary receiver operating characteristic curves were applied to summarize overall test performance. Nine studies met our inclusion criteria, the pooled sensitivity and specificity for FISH for diagnosing MM being 0.72 (95% CI 0.67-0.76) and 1.00 (95% CI 0.98-1.00), respectively. The positive likelihood ratio was 34.5 (95% CI 14.5-82.10), the negative likelihood ratio was 0.24 (95% CI 0.16-0.36), and the diagnostic odds ratio was 204.9 (95% CI 76.8-546.6), the area under the curve being 0.99. Our data suggest that the FISH assay is likely to be a useful diagnostic tool for confirming MM. However, considering the limited studies and patients included, further large scale studies are needed to confirm these findings.

Cytopathologic Diagnosis of Epithelioid and Mixed-Type Malignant Mesothelioma: Ten Years of Clinical Experience in Relation to International Guidelines

“…The commercially available UroVysion test (Abbot, Wiesbaden, Germany), adopted for pleural effusions, is useful in most MM cases. 38,39 The test contains centromeric probes for chromosomes 3, 7, and 17, together with a probe hybridizing to band 9p21, where genes for p14 and p16 are located. Two algorithms for interpretation are used: either 1 , and mesothelin (g) as markers of the mesothelial lineage, whereas there is no reactivity to carcinoembryonic antigen (CEA) (h), thyroid transcription factor 1 (TTF-1, absent brown nuclear staining) (i), or Napsin A (red) (i).…”

Diagnostic value of BRCA1‐associated protein‐1, glucose transporter‐1 and desmin expression in the discrimination between reactive mesothelial proliferation and malignant mesothelioma in tissues and effusions

“…Although the usefulness of IHC has been well‐proven, diagnostic accuracy rates of IHC markers vary and are not yet perfect. Diagnosis of MM can be improved further by the combined use of IHC antibodies or use of other ancillary tests such as the detection of homozygous deletion of p16INK gene by fluorescent in situ hybridisation (FISH) technique . However, IHC still remains the method of choice in daily practice as it is easily available, less labour intensive and relatively inexpensive.…”

Guidelines for the Cytopathologic Diagnosis of Epithelioid and Mixed-Type Malignant Mesothelioma

“…This can be performed by FISH analysis, and the use of 4 target sequences, such as in the Abbot UroVysion® kit, are sufficient in most cases [45]. Three probes of this kit label centromeric sequences on chromosomes 3, 7 and 17, thus showing gains or losses of the chromosome, while the fourth probe labels the 9p21 band containing the p16INK gene.…”