PMID- 28263126
OWN - NLM
STAT- MEDLINE
DCOM- 20171013
LR  - 20220331
IS  - 1195-9479 (Print)
IS  - 1195-9479 (Linking)
VI  - 24
IP  - 1
DP  - 2017 Feb
TI  - Fluorescence in situ hybridization (FISH) in the diagnosis of bladder and upper 
      tract urothelial carcinoma: the largest single-institution experience to date.
PG  - 8620-8626
AB  - INTRODUCTION: We evaluated the UroVysion (Abbott Molecular, IL, USA) fluorescence 
      in situ hybridization (FISH) assay for the diagnosis of urothelial cancer in 
      patients diagnosed with or suspected to have bladder, upper tract urothelial 
      carcinoma (UTUC), and combined upper and lower tract urothelial carcinoma (BC). 
      MATERIALS AND METHODS: A single institution retrospective analysis comparing 
      sensitivity, specificity, positive predictive value, and negative predictive 
      values for FISH and urinary cytology. FISH within 6 months of endoscopic 
      evaluation were obtained from outpatient voided urine samples. Our institutional 
      pathology department confirmed pathologic disease from specimens obtained during 
      endoscopic evaluations for lower tract disease. For upper tract disease, disease 
      was confirmed by retrograde ureteroscopy, biopsies of visual lesions, and 
      site-specific upper tract cytology. RESULTS: A total of 415 patients submitted 
      FISH specimens. Overall, FISH was more sensitive than cytology 54.9% in 
      comparison with cytology 42.2% (p = 0.01), specificity favored cytology 92.9% 
      compared to 73.5% with FISH (p < 0.01). For BC only patients, the same 
      significant finding of increased sensitivity and decreased specificity was 
      identified, but for UTUC alone and combined UTUC and BC, there was no significant 
      difference. Cytology had improved positive predictive value (PPV) over FISH, 
      76.9% in comparison to 64.6% (p = 0.02). Negative predictive value (NPV) also 
      favored cytology 74.2% versus 64.9% (p = 0.02). When analyzing individual 
      cohorts, cytology had improved PPV for BC alone patients. UTUC showed no 
      difference for PPV and NPV. For both UTUC and BC, NPV was slightly favored for 
      FISH over cytology 93.2% versus 91.2% (p = 0.03). CONCLUSIONS: Voided urine FISH 
      testing does offer a higher detection of urothelial carcinoma for BC compared to 
      voided cytology; however, specificity was worse. FISH does not appear to improve 
      detection of urothelial carcinoma in patients with either UTUC only or both BC 
      and UTUC.
FAU - Gomella, Leonard G
AU  - Gomella LG
AD  - Department of Urology, Sidney Kimmel Cancer Center, Thomas Jefferson University, 
      Philadelphia, Pennsylvania, USA.
FAU - Mann, Mark J
AU  - Mann MJ
FAU - Cleary, Ryan C
AU  - Cleary RC
FAU - Hubosky, Scott G
AU  - Hubosky SG
FAU - Bagley, Demetrius H
AU  - Bagley DH
FAU - Thumar, Adeep B
AU  - Thumar AB
FAU - McCue, Peter A
AU  - McCue PA
FAU - Lallas, Costas D
AU  - Lallas CD
FAU - Trabulsi, Edouard J
AU  - Trabulsi EJ
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - Canada
TA  - Can J Urol
JT  - The Canadian journal of urology
JID - 9515842
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Carcinoma, Transitional Cell/*diagnosis/pathology/urine
MH  - *Cytodiagnosis
MH  - Female
MH  - Humans
MH  - *In Situ Hybridization, Fluorescence
MH  - Male
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Retrospective Studies
MH  - Ureteral Neoplasms/*diagnosis/pathology/urine
MH  - Urinary Bladder Neoplasms/*diagnosis/pathology/urine
MH  - Urine/chemistry/cytology
EDAT- 2017/03/07 06:00
MHDA- 2017/10/14 06:00
CRDT- 2017/03/07 06:00
PHST- 2017/03/07 06:00 [entrez]
PHST- 2017/03/07 06:00 [pubmed]
PHST- 2017/10/14 06:00 [medline]
PST - ppublish
SO  - Can J Urol. 2017 Feb;24(1):8620-8626.