Prospective evaluation of fluorescence in situ hybridization for diagnosing urothelial carcinoma

Abstract

Abstract. Urothelial carcinoma (UC) is the most common type of cancer of the bladder and upper urinary tract, and is characterized by a high risk of recurrence and progression. Urine fluorescence in situ hybridization (FISH) is a technique that detects genetic aberrations in exfoliated cells in the urine, with specific probes for chromosomes 3, 7 and 17 and the p16 gene. To evaluate the diagnostic value of FISH in UC, 119 patients from November 2010 to June 2012 with suspected UC were recruited into a prospective, cross-sectional study and were followed up for 12-30 months. These patients received voided urine cytology and FISH tests, and underwent cystoscopy and/or ureteroscopy as a reference standard. The final diagnoses confirmed 73 patients with UC, located in the bladder, upper urinary tracts or the two. The sensitivity of FISH for detecting UC was superior to cytology, irrespective of tumor grade and stage: Overall, 80.8 vs. 32.9% (P<0.001); low grade, 75.8 vs. 12.1% (P<0.001); high grade, 85 vs. 50% (P<0.005); non-muscle-invasive, 81.1 vs. 28.3% (P<0.001) and muscle-invasive, 80 vs. 45% (P<0.05), respectively. The specificities of the two tests were similar; overall, the specificity was 89.1% for cytology vs. 100% for FISH, and no significant difference was observed between the methods. Notably, FISH exhibited 100% sensitivity for cytologically non-diagnostic UC, but 33.3% specificity. In conclusion, FISH is a reliable and non-invasive diagnostic tool for bladder and upper urinary tract UC, particularly in patients with low-grade or early stage

Application of fluorescence in situ hybridization in the detection of bladder transitional-cell carcinoma: A multi-center clinical study based on Chinese population

“…However, the unsatisfactory specificities reported to date in comparison with urine cytology have limited the clinical utility of these assays, possibly for screening and surveillance only [13] , [14] , [15] , [16] . Some other trails had proved FISH to be a more accurate tool in detecting and predicting recurrence for urothelial carcinoma patients [17] , [18] , [19] .…”

Timing of changing therapy from gemcitabine and cisplatin chemotherapy based on real‑world data of advanced urothelial carcinoma

“…Urothelial carcinoma (UC) is the most common cancer of the bladder and upper urinary tract and is invasive and lethal, especially in advanced and metastatic patients (1,2). Advanced UC patients generally have a poor prognosis, and only a few patients survive more than five years (3).…”

Urinary expression of genes involved in DNA methylation and histone modification for diagnosis of bladder cancer in patients with asymptomatic microscopic haematuria

“…Intense research has therefore been undertaken to identify easier, better, faster, more cost-effective urinary markers for UCB detection, aiming to single out the patients who may truly benefit from cystoscopy, and avoiding unnecessary testing and possible iatrogenic complications (8). Indeed, several urine-based markers have been shown to have a potential use as a non-invasive adjunct to cystoscopy for the detection of UCB (9)(10)(11)(12)(13)(14)(15), but none has yet fulfilled the criteria to be recommended for routine care (6).…”