PMID- 16287445
OWN - NLM
STAT- MEDLINE
DCOM- 20051223
LR  - 20191210
IS  - 1464-4096 (Print)
IS  - 1464-4096 (Linking)
VI  - 96
IP  - 9
DP  - 2005 Dec
TI  - Fluorescence in situ hybridization for detecting transitional cell carcinoma: 
      implications for clinical practice.
PG  - 1280-5
AB  - OBJECTIVE: To determine the diagnostic sensitivity of genetic studies using 
      fluorescence in situ hybridization (FISH) for detecting both new and recurrent 
      cases of transitional cell carcinoma (TCC) in a routine clinical practice 
      setting, as bladder cancer has a significant risk of recurrence and progression 
      to invasive disease and thus sensitive surveillance testing is very important. 
      PATIENTS AND METHODS: FISH was performed using the UroVysion kit (Vysis Inc., 
      Downers Grove, IL, USA) Consecutive patients were assessed using FISH, both to 
      evaluate those with a history of TCC or with suspicious symptoms, and the FISH 
      results were compared with concurrent biopsy and cytological assessments. 
      RESULTS: In all, 521 consecutive FISH tests from 300 patients were evaluated; 47% 
      had a history of bladder cancer and 53% had suspicious symptoms. Of the 521 FISH 
      tests, 24% were positive; concurrent cytology was available for 84% of the FISH 
      tests, with a concordance rate of 78% (6% were positive for both and 72% were 
      negative by both tests). For the discordant cases, FISH was positive and cytology 
      negative in 21% of cases, and cytology was positive with a negative FISH for 1%. 
      In all, 99 FISH tests had concurrent biopsy data. Of the 44 cases histologically 
      positive for TCC, 32 were FISH-positive, resulting in an overall sensitivity (95% 
      confidence interval) of 73 (60-88)%. FISH detected 95% of cases with high-grade 
      carcinoma, while only seven of these 17 were positive by concurrent cytological 
      assessment. FISH detected 56% and cytology detected 32% of low-grade lesions. 
      FISH detected all nine new cases with positive histology. Overall, the 
      specificity of FISH was 65 (53-78)%. Of 112 patients with previous TCC, 28 had a 
      recurrence; 22 of these had positive FISH results. CONCLUSION: FISH analysis has 
      a high sensitivity for detecting new cases of TCC, as well as recurrences. From 
      the present data FISH is considerably more sensitive and only slightly less 
      specific than cytology in diagnosing TCC. Therefore, we recommend FISH as a 
      useful initial diagnostic tool in patients suspected of both new and recurrent 
      TCC.
FAU - Laudadio, Jennifer
AU  - Laudadio J
AD  - Department of Pathology and Laboratory Medicine, Medical University of South 
      Carolina, Charleston, SC 29425, USA.
FAU - Keane, Thomas E
AU  - Keane TE
FAU - Reeves, Hugh M
AU  - Reeves HM
FAU - Savage, Stephen J
AU  - Savage SJ
FAU - Hoda, Rana S
AU  - Hoda RS
FAU - Lage, Janice M
AU  - Lage JM
FAU - Wolff, Daynna J
AU  - Wolff DJ
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
PL  - England
TA  - BJU Int
JT  - BJU international
JID - 100886721
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Carcinoma, Transitional Cell/*diagnosis/genetics
MH  - Female
MH  - Humans
MH  - In Situ Hybridization, Fluorescence/*standards
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Recurrence, Local/genetics
MH  - Sensitivity and Specificity
MH  - Urinary Bladder Neoplasms/*diagnosis/genetics
EDAT- 2005/11/17 09:00
MHDA- 2005/12/24 09:00
CRDT- 2005/11/17 09:00
PHST- 2005/11/17 09:00 [pubmed]
PHST- 2005/12/24 09:00 [medline]
PHST- 2005/11/17 09:00 [entrez]
AID - BJU5826 [pii]
AID - 10.1111/j.1464-410X.2005.05826.x [doi]
PST - ppublish
SO  - BJU Int. 2005 Dec;96(9):1280-5. doi: 10.1111/j.1464-410X.2005.05826.x.