Utility of fluorescence in situ hybridization in the diagnosis of upper urinary tract urothelial carcinoma

Luo, Bin; Li, Wen; Deng, Chao; Zheng, Fufu; Sun, Xiangzhou; Wang, Daohu; Dai, Yong

doi:10.1016/j.cancergencyto.2008.10.015

Cited by 51 publications

(42 citation statements)

References 16 publications

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“…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%

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: 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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“…retrospective, and the data available are insufficient (4,7,10). Thus, prospective, randomized studies are required.…”

Section: C B Amentioning

confidence: 99%

“…FISH technology is generally used for the diagnosis of bladder cancer in voided urine in China, due to its high sensitivity and specificity, but its use for detecting UTUCs is limited, due to its low reliability (10). Luo et al (10) reviewed the utility of FISH in the diagnosis of UTUC, but this type of prospective study has not been conducted in China thus far.…”

Section: Introductionmentioning

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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“…Although urine cytology is known to have low sensitivity for urothelial carcinoma, particularly in low grade carcinomas (24)(25)(26)(27) and in tumors of the UUT (28)(29)(30)(31), the specificity is excellent, especially for CIS and high grade lesions (32). In the UUT, positive -urine cytology is highly suggestive of UTUC when evaluation of the lower tract reveals no disease.…”

Section: Cytology Specimensmentioning

confidence: 99%

“…Furthermore, urine cytology has been shown to improve the detection and grading of tumors in biopsies (5,8,31), and positive urine cytology in UTUC has been associated with higher stage (pT2+) tumors (33). Directed sampling of the UUT via brushings and washings may help increase sensitivity, as can addition of fluorescence in situ hybridization (FISH) assays (28)(29)(30).…”

Section: Cytology Specimensmentioning

confidence: 99%

Pathology of Upper Tract Urothelial Carcinoma with Emphasis on Staging

Mazzucchelli

Scarpelli

Galosi³

et al. 2014

Int J Immunopathol Pharmacol

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The first two authors contributed equally to this work Classification of upper tract urothelial preneoplastic and neoplastic lesions mirrors that of the urinary bladder, with aU lesions of the bladder urothelium being possible in the upper tract and vice versa. There are three major groups of non-invasive urothelial neoplasms: flat, papillary, and inverted. These three groups share a similar morphological spectrum of intraurothelial changes, ranging from hyperplasia to dysplasia to carcinoma in situ. However, they differ in terms of architectural growth pattern compared to the surrounding non-neoplastic mucosal surface. Infiltrating urothelial carcinoma is defined as a urothelial tumor that invades beyond the basement membrane. Unlike in non-invasive papillary urothelial neoplasms (pTa), the role of histologic grade in pTl and higher stage tumors has been suggested to be of only relative importance. The vast majority of tumors of the upper urinary tract are urothelial carcinoma. More commonly seen, however, are foci ofsquamous differentiation and, less frequently, glandular differentiation. Pure urothelial carcinomas also display a wide range of variant morphologies, and recognition of these morphologies is important for diagnosis, classification, and prognosis.The pathology ofupper tract urothelial carcinoma (UTUC) is considered to be the same as that of urothelial carcinoma of the bladder (UCB) (1-3). While this assumption seems reasonable given that the histologic features of UTUC and UCB are microscopically identical, a growing body of evidence has begun to suggest that differences between these two cancers do exist (4). Nevertheless, studies specific to the pathology of UTUC remain rare and much of what is known about UTUC is derived from studies on UCB. CLASSIFICATION AND GRADINGUreteroscopic evaluation with biopsy is currently the gold standard for diagnosing tumors of the upper

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Utility of fluorescence in situ hybridization in the diagnosis of upper urinary tract urothelial carcinoma

Cited by 51 publications

References 16 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

Pathology of Upper Tract Urothelial Carcinoma with Emphasis on Staging

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