title: Utility of a multiprobe fluorescence in situ hybridization assay in the detection of superficial urothelial bladder cancer.
abstract: We evaluated the performance of a multiprobe FISH (fluorescence in situ hybridization) assay for noninvasive detection of superficial urothelial carcinoma (UC) in the bladder, in comparison to urinary cytology. Voided urine samples from 74 patients with superficial UC were analyzed by both techniques. Urine samples from 19 patients with muscle-invasive tumors and from 19 healthy control subjects were also studied. For FISH analysis, labeled probes for chromosomes 3, 7, 9, and 17 were used to assess chromosomal abnormalities indicative of malignancy. We found a significant difference between the overall sensitivity of FISH and cytology in superficial UC detection (70.3 versus 35.1%, respectively; P < 0.0001). This significant difference was maintained when superficial UCs were broken down into low grade (52.8 versus 13.9%, respectively; P < 0.0005) and high grade (86.8 versus 55.3%, respectively; P < 0.0015) tumors. Overall specificity was 100% for cytology and 94.7% for FISH (difference not significant). Of patients with suspicious cytology, 69% were positive by FISH. Together, these findings suggest that FISH assay for chromosomes 3, 7, 9, and 17 has a higher sensitivity than cytology and a similar specificity in the detection of superficial UC--which could be useful for reducing some cystoscopies in the accurate follow-up usually performed in these patients.
authors.affiliation: Department of Urology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Villarroel 170, 08036 Barcelona, Spain.
authors.forename: Mercedes
authors.initials: M
authors.lastname: Marín-Aguilera
authors.forename: Lourdes
authors.initials: L
authors.lastname: Mengual
authors.forename: María José
authors.initials: MJ
authors.lastname: Ribal
authors.forename: Moisès
authors.initials: M
authors.lastname: Burset
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Arce
authors.forename: Elisabet
authors.initials: E
authors.lastname: Ars
authors.forename: Artur
authors.initials: A
authors.lastname: Oliver
authors.forename: Humberto
authors.initials: H
authors.lastname: Villavicencio
authors.forename: Ferran
authors.initials: F
authors.lastname: Algaba
authors.forename: Antonio
authors.initials: A
authors.lastname: Alcaraz
mesh_terms: D000368:Aged; D003581:Cytodiagnosis / Q000379:methods; D005260:Female; D006801:Humans; D017404:In Situ Hybridization, Fluorescence / Q000379:methods*; D008297:Male; D012680:Sensitivity and Specificity; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000652:urine