title: Fluorescence in situ hybridization for detecting upper urinary tract tumors--a preliminary report.
abstract: OBJECTIVE
  To evaluate fluorescence in situ hybridization (FISH) in voided urine specimens and selective upper urinary tract washings obtained from patients with suspected transitional cell cancer of the upper urinary tract (UT-TCC).
  
  
  METHODS
  A total of 16 patients with suspected UT-TCC were included in the study. All patients underwent urinary tract imaging. Endoscopy was also performed. Voided urine specimens from all patients and ureteral washings were subjected to cytologic examination and FISH analysis (UroVysion probe set). If indicated, surgery (nephroureterectomy or ureterectomy) was performed.
  
  
  RESULTS
  Of the 16 patients, 9 (56.25%) were diagnosed with UT-TCC. None of the remaining patients was diagnosed with UT-TCC after a mean follow-up of 21.3 months (median 20, range 11 to 36). For FISH analysis, the sensitivity was 87.5% and specificity 80%. FISH analysis was not possible in 1 patient with UT-TCC because of an insufficient number of cells. For cytology, the sensitivity was 60% and specificity 80%. In patients with UT-TCC, the cytologic findings were inconclusive (atypia of uncertain significance) in 4 patients (44.4%). In contrast to the cytology findings, all results of the FISH analysis of the upper urinary tract washings matched those of the voided urine samples.
  
  
  CONCLUSIONS
  Our preliminary data suggest that FISH analysis of voided urine might be a useful ancillary test in the detection of UT-TCC with excellent sensitivity and specificity. If confirmed in larger studies, FISH might contribute to a more reliable and less-invasive diagnostic approach to UT-TCC.
authors.affiliation: Department of Urology, Medical University Innsbruck, Innsbruck, Austria.
authors.forename: Thomas
authors.initials: T
authors.lastname: Akkad
authors.forename: Andrea
authors.initials: A
authors.lastname: Brunner
authors.forename: Leo
authors.initials: L
authors.lastname: Pallwein
authors.forename: Christian
authors.initials: C
authors.lastname: Gozzi
authors.forename: Georg
authors.initials: G
authors.lastname: Bartsch
authors.forename: Gregor
authors.initials: G
authors.lastname: Mikuz
authors.forename: Hannes
authors.initials: H
authors.lastname: Steiner
authors.forename: Irmgard
authors.initials: I
authors.lastname: Verdorfer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000175:diagnosis* / Q000601:surgery / Q000652:urine; D003581:Cytodiagnosis; D005260:Female; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D007680:Kidney Neoplasms / Q000175:diagnosis* / Q000601:surgery / Q000652:urine; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014516:Ureteral Neoplasms / Q000175:diagnosis* / Q000601:surgery / Q000652:urine; D014556:Urine / Q000166:cytology