title: Prognostic significance of nondiagnostic molecular changes in urine detected by UroVysion fluorescence in situ hybridization during surveillance for bladder cancer.
abstract: OBJECTIVE
  To determine the outcomes for patients with nondiagnostic fluorescence in situ hybridization (FISH) (ie, < 4 gains of chromosomes 3, 7, or 17 in < or = 3 cells). FISH detects urothelial carcinoma and is especially beneficial in patients with negative or atypical urine cytology findings. A positive result is defined as a gain of > or = 2 chromosomes (3, 7, or 17) in 4 cells, isolated loss of 9p21 in 12 cells, or isolated gains of only 1 chromosome in > or = 10% of cells. Most FISH-positive patients will develop recurrent urothelial carcinoma within 1 year.
  
  
  METHODS
  We compared the data from 149 patients with a nondiagnostic FISH result and > or = 30 months of follow-up with the data from patients with a negative FISH result from the same period. The time to conversion to a positive FISH result or the development of a bladder tumor was recorded.
  
  
  RESULTS
  Patients with nondiagnostic FISH results had significantly greater rates of progression to positive FISH findings or the development of a bladder tumor than did patients with negative FISH findings. Most progression occurred within 1 year. Patients with nondiagnostic FISH results and concurrent negative cytology and cystoscopy had a very low risk of developing recurrent disease, similar to that found with truly negative FISH results.
  
  
  CONCLUSIONS
  Nondiagnostic FISH results are related to a greater risk of progression to positive FISH results and tumor recurrence than those with negative FISH findings. However, after controlling for negative cytologic and cystoscopic status, a nondiagnostic FISH result does not appear to be an independent predictor of disease recurrence, and aggressive investigation is not warranted.
authors.affiliation: Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio 44195, USA.
authors.forename: Carvell T
authors.initials: CT
authors.lastname: Nguyen
authors.forename: David B
authors.initials: DB
authors.lastname: Litt
authors.forename: Sandra E
authors.initials: SE
authors.lastname: Dolar
authors.forename: James C
authors.initials: JC
authors.lastname: Ulchaker
authors.forename: J Stephen
authors.initials: JS
authors.lastname: Jones
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Brainard
mesh_terms: D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000652:urine*; D005260:Female; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000652:urine*; D011159:Population Surveillance; D011379:Prognosis; D018570:Risk Assessment; D001749:Urinary Bladder Neoplasms / Q000652:urine*