Fluorescence In Situ Hybridization for Detecting Upper Urinary Tract Tumors—A Preliminary Report

Akkad, Thomas; Brunner, Andrea; Pallwein, Leo; Gozzi, Christian; Bartsch, Georg; Mikuz, Gregor; Steiner, Hannes; Verdorfer, Irmgard

doi:10.1016/j.urology.2007.06.1103

Cited by 49 publications

(38 citation statements)

References 24 publications

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“…It is of note that none of the patients with proven UUT-TCC in our cohort had false-negative FISH results. Although Akkad et al [15] recently reported similar result in their study, the FISH false-negative in our series was remarkably low compared with that (23.3%) reported by Marin-Aguilera et al [14]. There are several possible explanations for this finding.…”

Section: Discussionsupporting

confidence: 71%

“…To date, there are only limited data to reveal the utility of FISH as a non-invasive test in the detection of UUT-TCC. These data suggested that FISH analysis performed on voided urine is feasible and that FISH could provide a reliable and less-invasive ancillary test for the detection of UUT-TCC [14][15][16][17]. However, no study has specifically evaluated the role of FISH assay in the detection of UUT-TCC in patients with asymptomatic hematuria and negative urine cytology to date.…”

Section: Discussionmentioning

confidence: 99%

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Fluorescence in situ hybridization assay detects upper urinary tract transitional cell carcinoma in patients with asymptomatic hematuria and negative urine cytology

Huang¹,

Li²,

Pang³

et al. 2012

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We evaluated the performance of a multiprobe FISH (fluorescence in situ hybridization) assay for noninvasive detection of upper urinary tract transitional cell carcinoma (UUT-TCC) in patients with asymptomatic hematuria and negative urine cytology. Voided urine samples from 285 patients with asymptomatic hematuria and negative urine cytology were prospectively analyzed by FISH technique. FISH assays were performed to detect chromosomal changes frequently associated with TCC, including aneuploidy of chromosomes 3, 7 and 17, and loss of the 9p21 locus. Eleven (3.9%) had a positive FISH result. Of the 11 patients, nine (81.8%) were found to have a TCC of the upper urinary tract, while no patients with negative FISH findings were found to have UUT-TCC. In this selected cohort, the sensitivity and specificity of FISH for the detection of UUT-TCC was 100% and 99.3%, respectively. Our preliminary data suggest that the clinical utility of FISH assay of chromosomes 3, 7, 9, and 17 as a noninvasive ancillary test for the diagnosis of UUT-TCC in a selected patient population with asymptomatic hematuria and negative urine cytology and by significant high sensitivity and specificity may be a reliable diagnostic approach for early detection of UUT-TCC patients. Further larger prospective and multicenter trials are needed to confirm our results.

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Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Fluorescence in situ hybridization assay detects upper urinary tract transitional cell carcinoma in patients with asymptomatic hematuria and negative urine cytology

Huang¹,

Li²,

Pang³

et al. 2012

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“…ImmunoCyt/uCyt+ test, voided or clean catch urine cytology, radiographic or ultrasound imaging and ureteroscopy are the most common diagnostic methods for UTUC (7). However, urine cytology has been reported to be of little value in evaluating unclear or suspicious findings of the upper urinary tract obtained by imaging studies (14,15), which have a sensitivity of 30-50% (16,17). Furthermore, radiographic and ultrasound imaging have low sensitivity for the detection of carcinoma in situ in small lesions, and ureteroscopy is an invasive method which patients prefer to avoid (4).…”

Section: Discussionmentioning

confidence: 99%

Prospective evaluation of FISH for detecting upper tract urothelial carcinoma in voided urine specimens

et al. 2016

Oncology Letters

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Abstract. The aim of the present study was to estimate the diagnostic value of fluorescence in situ hybridization (FISH) analysis of tumor cells in voided urine specimens for detecting upper tract urothelial carcinoma (UTUC). Cytology and FISH analyses were conducted on voided urine collected in the morning from 125 patients with suspected UTUC. During follow-up, ureteroscopy with biopsy and histopathology were used to confirm the presence of tumors. The average follow-up time was 23.8 months (range, 6-36 months). A total of 8 patients who could not be contacted until the last follow-up were excluded from the study. Of the remaining 117 patients, 19 were histologically demonstrated to have UTUC, of whom, 3 patients had stage pTis disease, 6 had stage pTa disease, 5 had stage pT1 disease and 5 had stage pT2 disease (7 G1, 8 G2 and 4 G3). The overall sensitivity of FISH to detect UTUCs in voided urine specimens was 84.21% (16/19), whereas that of cytology was 42.11% (8/19) (P<0.05). The overall specificity of FISH to detect UTUCs in voided urine specimens was 89.80% (88/98), compared with 94.90% (93/98) of cytology (P>0.05). The positive predictive value (PPV) and negative predictive value of FISH were 80.00% (16/20) and 97.78% (88/90), respectively, whereas those of cytology were 100.00% (8/8) (P>0.05) and 90.29% (93/103) (P>0.05), respectively. The present data indicated that FISH was a method capable of detecting UTUCs in voided urine specimens with good sensitivity and specificity, although it exhibited a high rate of false positivity and low PPV.

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“…Similar to bladder cancer, the FISH test has shown better sensitivity and equal specificity compared with cytology [6,14,15]. Results of FISH analysis obtained by upper tract washings have shown to be consistent with those obtained from voided samples [14]. However, the role of FISH for upper urothelial tract recurrence after radical cystectomy has not been assessed to date.…”

Section: Discussionmentioning

confidence: 99%

The role of FISH and cytology in upper urinary tract surveillance after radical cystectomy for bladder cancer

Fernández

Parikh

Grossman

et al. 2012

Urologic Oncology: Seminars and Original Investigations

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Objectives Cytology and fluorescence in situ hybridization (FISH) (Urovysion) assay are often used during upper urinary tract surveillance in patients following radical cystectomy with urinary diversion, without much available data regarding efficacy in this population. Here, we evaluate the value of FISH and cytology in detecting upper tract recurrence in the face of a urinary diversion. Materials and methods A review of our cystectomy database revealed 270 patients who had at least one FISH and/or cytology assay performed during surveillance after radical cystectomy. Workup included upper tract imaging in all patients and upper tract endoscopy as indicated. A total of 163 FISH assays and 474 urinary cytology examinations were included in the analysis. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of FISH and cytology were assessed. Results Ten patients (3.4%) developed upper tract recurrence after a median follow-up time of 31 months (2–202). All but 1 patient presented either with gross hematuria or positive finding on imaging; 6 had positive FISH and cytology, and 2 had positive cytology only (no FISH done). For detection of upper tract recurrence, sensitivity, specificity, PPV, and NPV of cytology were 80.0%, 85.6%, 10.7%, and 99.5%, respectively; and that for FISH were 85.7%, 86.5%, 23.1%, and 99.2%, respectively. Conclusions The FISH assay and urinary cytology both demonstrate high rates of false positivity and are useful mainly for their negative predictive ability in patients with a urinary diversion. Unless prospective trials show otherwise, both— or at least the more expensive test— can be omitted from surveillance strategies.

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Fluorescence In Situ Hybridization for Detecting Upper Urinary Tract Tumors—A Preliminary Report

Cited by 49 publications

References 24 publications

Fluorescence in situ hybridization assay detects upper urinary tract transitional cell carcinoma in patients with asymptomatic hematuria and negative urine cytology

Fluorescence in situ hybridization assay detects upper urinary tract transitional cell carcinoma in patients with asymptomatic hematuria and negative urine cytology

Prospective evaluation of FISH for detecting upper tract urothelial carcinoma in voided urine specimens

The role of FISH and cytology in upper urinary tract surveillance after radical cystectomy for bladder cancer

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