Evaluation of UroVysion for Urachal Carcinoma Detection

Abstract

Background: Patients with hematuria who are positive for urinary fluorescence in situ hybridization (FISH) are generally considered to have urothelial carcinoma. We determined whether UroVysion FISH could be used for the diagnosis of urachal carcinoma. Methods: Seven cases of urachal carcinoma with haematuria subjected to FISH analysis were retrospectively analyzed in our hospital from May 2012 to November 2019. Paraffin-embedded tissue sections from one FISH-positive and one FISH-negative urachal carcinoma were processed in strict accordance with the instructions of the UroVysion kit. Meanwhile, FISH data from the other 414 hematuria patients were collected as controls. Results: All 7 patients with urachal carcinoma were diagnosed with adenocarcinoma. According to Sheldon stage, six patients had stage IIIa and one patient had stage IVb. The sensitivity and specificity of urinary FISH for the diagnosis of urachal carcinoma were 71.43% (5/7) and 94.61% (281/297), respectively. The rates of polysomy for chromosomes 3 and 7 in positive patients were both 100% (5/5), whereas the rate of polysomy for chromosome 17 was 40% (2/5), and the chromosome 9p21 region (p16) gene deletion rate was 20% (1/5). Histological assessment and cytological FISH were consistent for urachal carcinoma. No significant difference was observed in the diagnostic efficacy between urachal carcinoma and urothelial carcinoma (71.43 vs. 87.18%, P = 0.245). Conclusions: Taken together, UroVysion FISH was found to be positive in a high proportion of pathologically confirmed urachal carcinoma of late stage with hematuria. Its chromosomal aberrations may be different from those of urothelial carcinoma, but more studies are needed to clarify their genetic background. Not all tumors showing abnormalities by FISH are urothelial carcinomas.

Clinical and Radiological Features of Urachal Carcinoma and Infection

“…Antibiotics and complete resection of the urachal remnant are usually used for the treatment of infection, which results in a good prognosis. For patients with urachal carcinoma, resection of the urachus, umbilicus, and partial cystectomy with or without pelvic lymphadenectomy are generally recommended, but the prognosis is limited ( 18 , 19 ).…”

Which Test is the Best? In the Diagnosis and monitoring of Bladder Carcinoma

“…Also the isoenzyme GST-π in urine seems useful as a marker of bladder cancer . Taken together, UroVysion FISH was found to be positive in a high proportion of urachal carcinoma as well [13][14][15]. ApoA-1 showed high sensitivity and specificity, so it could be a useful biomarker in the diagnosis of bladder cancer as well [16].…”

Current Management of Urachal Carcinoma: An Evidence-based Guide for Clinical Practice

“…Ultrasonography can show a supravesical inhomogeneous mass located in the midline, sometimes associated with calcifications that are considered pathognomonic. A computed tomography (CT) scan or magnetic resonance imaging (MRI) is useful for evaluating the mass and performing clinical staging, detecting possible organ invasion, lymph node enlargement, or distant metastasis [3] , [5] .…”

“…Urinary UroVysion FISH has recently been studied as a potential tool for the diagnosis of UrC [5] . It has been found to be positive in a high proportion of pathologically confirmed UrC cases, with sensitivity and specificity of 71.43% and 94.61%, respectively [6] .…”