title: FISH analysis of washing urine from the upper urinary tract for the detection of urothelial cancers.
abstract: BACKGROUND
  To evaluate FISH analysis of washing urine from the upper urinary tract (UUT) in comparison with cytology (Cyt) for the detection of urothelial cancers.
  
  
  METHODS
  In 82 patients with symptoms or abnormalities of the UUT sampling of washing urine for FISH and Cyt and a stepwise diagnostic work-up (e.g. retrograde ureteropyelography, ureterorenoscopy and endoscopic biopsy) were performed. In case of endoscopically and/or histologically proven malignancy patients either underwent nephroureterectomy, partial ureterectomy or local treatment. Sensitivity and specificity for FISH and Cyt as well as its combination were determined.
  
  
  RESULTS
  Urothelial cancer of the UUT was detected in 20 patients. Eleven patients underwent nephroureterectomy, six partial ureterectomy and three endoscopic tumour treatment. This revealed nine pTa, three pT1 and seven muscle-invasive tumours. Twelve tumours were classified as low and seven as high-grade tumours. In one patient with a macroscopic unequivocal finding of tumour, endoscopic laser ablation without histologic confirmation was performed. FISH was evaluable in 76 patients and detected 16 tumours with a sensitivity and specificity of 84.2 and 91.1 %, respectively. Cyt was performed in 79 and was evaluable in 78 patients. It detected ten tumours with a sensitivity and specificity of 52.6 and 91.4 %, respectively. Cyt and FISH together detected 19 tumours with (sensitivity 100 % and specificity 83.6 %).
  
  
  CONCLUSIONS
  FISH was more sensitive than and equally specific to Cyt in the detection of urothelial cancers of the UUT. Both markers in combination revealed the best sensitivity, making it a possible approach in future settings.
authors.affiliation: Department of Urology, Jena University Hospital, Lessingstr. 1, 07743, Jena, Germany.
authors.forename: Torsten
authors.initials: T
authors.lastname: Gruschwitz
authors.forename: Mieczyslaw
authors.initials: M
authors.lastname: Gajda
authors.forename: Astrid
authors.initials: A
authors.lastname: Enkelmann
authors.forename: Marc-Oliver
authors.initials: MO
authors.lastname: Grimm
authors.forename: Heiko
authors.initials: H
authors.lastname: Wunderlich
authors.forename: Marcus
authors.initials: M
authors.lastname: Horstmann
authors.forename: Kerstin
authors.initials: K
authors.lastname: Junker
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003581:Cytodiagnosis; D005260:Female; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D007680:Kidney Neoplasms / Q000473:pathology* / Q000652:urine*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014516:Ureteral Neoplasms / Q000473:pathology* / Q000652:urine*
references.citation: Cancer Genet Cytogenet. 2009 Mar;189(2):93-7
references.pmid: 19215789
references.citation: World J Urol. 2013 Feb;31(1):69-76
references.pmid: 23070533
references.citation: Cancer Genet Cytogenet. 2010 Dec;203(2):238-46
references.pmid: 21156239
references.citation: Urol Oncol. 2008 Nov-Dec;26(6):646-51
references.pmid: 18367109
references.citation: Neoplasma. 2012;59(4):355-60
references.pmid: 22489689
references.citation: Eur Urol. 2010 Aug;58(2):288-92
references.pmid: 20471154
references.citation: Eur Urol. 2011 Sep;60(3):484-92
references.pmid: 21684071
references.citation: World J Urol. 2012 Apr;30(2):271-5
references.pmid: 21805177
references.citation: Urology. 2006 Mar;67(3 Suppl 1):35-45; discussion 45-7
references.pmid: 16530074
references.citation: J Urol. 2002 May;167(5):2001-6
references.pmid: 11956427
references.citation: J Clin Pathol. 1986 Mar;39(3):297-305
references.pmid: 3958217
references.citation: J Urol. 2002 Nov;168(5):1950-4
references.pmid: 12394683
references.citation: Urology. 2003 Jan;61(1):109-18; discussion 118
references.pmid: 12559279
references.citation: J Urol. 2000 Jan;163(1):52-5
references.pmid: 10604312
references.citation: J Urol. 2003 Jun;169(6):2101-5
references.pmid: 12771727
references.citation: Am J Clin Pathol. 2001 Jul;116(1):79-86
references.pmid: 11447756
references.citation: Cancer Genet Cytogenet. 1999 Dec;115(2):123-7
references.pmid: 10598145
references.citation: Urology. 2007 Oct;70(4):753-7
references.pmid: 17991550
references.citation: J Urol. 2000 Nov;164(5):1768-75
references.pmid: 11025767
references.citation: Acta Cytol. 1962 May-Jun;6:255-66
references.pmid: 13923771
references.citation: Cancer Genet Cytogenet. 2007 Mar;173(2):131-5
references.pmid: 17321328
references.citation: Acta Cytol. 2012;56(5):533-8
references.pmid: 23075895