PMID- 12771727
OWN - NLM
STAT- MEDLINE
DCOM- 20030610
LR  - 20220331
IS  - 0022-5347 (Print)
IS  - 0022-5347 (Linking)
VI  - 169
IP  - 6
DP  - 2003 Jun
TI  - Multitarget fluorescence in situ hybridization assay detects transitional cell 
      carcinoma in the majority of patients with bladder cancer and atypical or 
      negative urine cytology.
PG  - 2101-5
AB  - PURPOSE: The multitarget fluorescence in situ hybridization (FISH) probe set 
      UroVysion (Vysis, Downers Grove, Illinois), containing probes to chromosomes 3, 7 
      and 17, and to the 9p21 band, has been recently shown to have high sensitivity 
      and specificity for detecting transitional cell carcinoma. In this study we 
      retrospectively tested 120 urine samples from patients with atypical, suspicious 
      and negative cytology for whom concurrent and followup bladder biopsy data were 
      available. We evaluated the ability of FISH to identify malignant cells in 
      cytologically equivocal or negative cases. MATERIALS AND METHODS: Archived slides 
      from 120 voided (47) or instrumented (73) urine cytology specimens from patients 
      with concurrent bladder biopsy and a minimum of 12 months of biopsy followup were 
      subjected to hybridization with UroVysion. The cohort included patients with 
      biopsy proven transitional cell carcinoma, which was grades 1 to 3 in 23, 35 and 
      24, respectively, and stages pTis in 3, pTa in 64, pT1 in 6, pT2 in 6 and pT4 in 
      3, while it showed negative histology in 38. Cytology findings were suspicious, 
      atypical and negative for transitional cell carcinoma in 31, 49 and 40 cases, 
      respectively. A positive FISH result was defined as 5 transitional cells or 
      greater with a gain of 2 or more of chromosomes 3, 7 or 17, 12 cells or greater 
      with 9p21 deletion, or 10% or greater of cells with isolated trisomy of 1 of 
      chromosomes 3, 7 and 17. RESULTS: All except 12 of the 82 biopsy proven 
      transitional cell carcinoma cases (11 pTa and 1 pT1 tumors) were positive by FISH 
      (85% sensitivity). Sensitivity in patients with suspicious, atypical and negative 
      cytology was 100%, 89% and 60%, respectively. Nine patients with atypical 
      cytology had positive FISH in the setting of a negative concurrent bladder 
      biopsy. However, 8 of these 9 patients (89%) had biopsy proven transitional cell 
      carcinoma within 12 months following the date when the sample tested by FISH was 
      obtained. The last of these patients with false-positive results had previously 
      documented pTis disease, which was also present in the next bladder biopsy 15 
      months following the positive FISH result. The remaining 29 specimens from 
      patients with negative biopsy and a negative 12-month followup tested negative by 
      FISH (97% overall specificity). CONCLUSIONS: The UroVysion FISH assay provides 
      high sensitivity and specificity to detect transitional cell carcinoma in 
      cytologically equivocal and negative urine samples. These results emphasize the 
      important role of this assay in the management of bladder cancer.
FAU - Skacel, Marek
AU  - Skacel M
AD  - Department of Anatomic and Clinical Pathology, Cleveland Clinic Foundation, 
      Cleveland, Ohio, USA.
FAU - Fahmy, Mona
AU  - Fahmy M
FAU - Brainard, Jennifer A
AU  - Brainard JA
FAU - Pettay, James D
AU  - Pettay JD
FAU - Biscotti, Charles V
AU  - Biscotti CV
FAU - Liou, Louis S
AU  - Liou LS
FAU - Procop, Gary W
AU  - Procop GW
FAU - Jones, J Stephen
AU  - Jones JS
FAU - Ulchaker, James
AU  - Ulchaker J
FAU - Zippe, Craig D
AU  - Zippe CD
FAU - Tubbs, Raymond R
AU  - Tubbs RR
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Urol
JT  - The Journal of urology
JID - 0376374
SB  - IM
MH  - Biopsy
MH  - Carcinoma, Transitional Cell/*diagnosis
MH  - Cytodiagnosis
MH  - Humans
MH  - *In Situ Hybridization, Fluorescence
MH  - Retrospective Studies
MH  - Sensitivity and Specificity
MH  - Urinary Bladder/pathology
MH  - Urinary Bladder Neoplasms/*diagnosis
MH  - Urine/*cytology
EDAT- 2003/05/29 05:00
MHDA- 2003/06/11 05:00
CRDT- 2003/05/29 05:00
PHST- 2003/05/29 05:00 [pubmed]
PHST- 2003/06/11 05:00 [medline]
PHST- 2003/05/29 05:00 [entrez]
AID - S0022-5347(05)63541-0 [pii]
AID - 10.1097/01.ju.0000066842.45464.cc [doi]
PST - ppublish
SO  - J Urol. 2003 Jun;169(6):2101-5. doi: 10.1097/01.ju.0000066842.45464.cc.