title: Combined analysis of morphology and fluorescence in situ hybridization significantly increases accuracy of bladder cancer detection in voided urine samples.
abstract: OBJECTIVE
  To evaluate a combined analysis approach that involves cytologic evaluation and fluorescence in situ hybridization analysis for detecting cancer cells in voided urine samples using an automated scanning station.
  
  
  METHODS
  Voided urine samples from 41 patients suspected of having transitional cell carcinoma were stained with May-Grünwald Giemsa stain, scanned for atypical or suspicious cells, destained, and hybridized with a mixture of fluorescent-labeled probes. Samples were tested using either the UroVysion probe or by a mix of chromosomes 3, 7, and 17 centromeric probes. A case was regarded as positive when at least one cell was abnormal in both aspects, morphology and fluorescence in situ hybridization. Patients were evaluated concomitantly by cytology, cytoscopy, and biopsy, if indicated.
  
  
  RESULTS
  Overall, 26 samples were positive by combined analysis. Biopsy-proven transitional cell carcinoma was positive by combined analysis in all cases (100%) and in 13 cases (61.9%) by cytology (P = 0.0133). The advantage of the combined analysis was noted mostly in low-grade and superficial tumors for which the sensitivity of cytology reached 30% (P = 0.023) and 27.27% (P = 0.0133), respectively. Specificity was 100%.
  
  
  CONCLUSIONS
  Our results have shown that combined analysis for the presence of transitional cell carcinoma cells is a powerful tool, providing high sensitivity and specificity, and may offer a new scheme for bladder cancer management.
authors.affiliation: BioView Limited, Rehovot, Israel. michal@bioview.co.il
authors.forename: Michal
authors.initials: M
authors.lastname: Daniely
authors.forename: Ronny
authors.initials: R
authors.lastname: Rona
authors.forename: Tal
authors.initials: T
authors.lastname: Kaplan
authors.forename: Shirley
authors.initials: S
authors.lastname: Olsfanger
authors.forename: Lea
authors.initials: L
authors.lastname: Elboim
authors.forename: Yulia
authors.initials: Y
authors.lastname: Zilberstien
authors.forename: Avner
authors.initials: A
authors.lastname: Friberger
authors.forename: Dvora
authors.initials: D
authors.lastname: Kidron
authors.forename: Eran
authors.initials: E
authors.lastname: Kaplan
authors.forename: Sylvia
authors.initials: S
authors.lastname: Lew
authors.forename: Ilan
authors.initials: I
authors.lastname: Leibovitch
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000473:pathology* / Q000652:urine*; D005260:Female; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D001749:Urinary Bladder Neoplasms / Q000473:pathology* / Q000652:urine*