A comparison of cytology and fluorescence in situ hybridization for the detection of urothelial carcinoma
A comparison of cytology and fluorescence in situ hybridization for the detection of urothelial carcinoma
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DOI：
10.1016/s0022-5347(05)67104-2
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发表时间：
2000-11-01
影响因子：
6.6
通讯作者：
Jenkins, RB
中科院分区：
文献类型：
--
作者：
Halling, KC;King, W;Jenkins, RB
目的：我们确定的相对灵敏度的细胞学和荧光原位杂交（FISH）检测尿路上皮carcinoma.Materials和Methods：荧光标记探针的混合物的着丝粒染色体3，7和17，带9 p21（P16/CDKN 2A基因）被用来评估尿细胞染色体异常恶性肿瘤的指示。共分析了265例患者的280份尿液标本，其中150例有尿路上皮癌病史，115例无尿路上皮癌病史。FISH分析是在事先不知道临床结果的情况下进行的，即活检、膀胱镜检查和细胞学结果。结果：265例患者中，有75例活检组织在FISH分析中显示尿路上皮癌。尿细胞学对pTa（36例）、pTis（18例）和pT 1-pT 4（15例）肿瘤的敏感性分别为47%、78%和60%，总敏感性为58%。FISH对pTa（37例）、pTis（17例）和pT 1-pT 4（19例）肿瘤的敏感性分别为65%、100%和95%，总敏感性为81%。对于pTis（p = 0.046）、pT 1-pT 4（p = 0.025）、3级（p = 0.003）和所有肿瘤（p = 0.001），FISH比细胞学显著更敏感。在膀胱镜检查无尿路上皮癌和无尿路上皮癌病史的患者中，细胞学和FISH的特异性分别为98%和96%（p = 0.564）。结论：FISH检测尿路上皮癌的敏感性上级，细胞学和FISH对尿路上皮癌的特异性无显著差异。需要进一步的前瞻性研究，但FISH有可能显着改善尿路上皮癌的治疗。
Purpose: We determine the relative sensitivities of cytology and fluorescence in situ hybridization (FISH) for the detection of urothelial carcinoma.Materials and Methods: A mixture of fluorescent labeled probes to the centromeres of chromosomes 3, 7 and 17, and band 9p21 (P16/CDKN2A gene) was used to assess urinary cells for chromosomal abnormalities indicative of malignancy. A total of 280 urine specimens from 265 patients, including 150 with a history of urothelial carcinoma and 115 without a history of urothelial carcinoma, were analyzed. FISH analysis was performed without prior knowledge of clinical findings, that is biopsy, cystoscopy and cytology results. A positive result was defined as 5 or more urinary cells with gains of 2 or more chromosomes.Results: A total of 75 biopsies showed urothelial carcinoma at FISH analysis among the 265 patients. The sensitivity of urine cytology for pTa (36 cases), pTis (18) and pT1-pT4 (15) tumors was 47%, 78% and 60%, respectively, for an overall sensitivity of 58%. The sensitivity of FISH for pTa (37 cases), pTis (17) and pT1-pT4 (19) tumors was 65%, 100% and 95%, respectively, for an overall sensitivity of 81%. FISH was significantly more sensitive than cytology for pTis (p = 0.046), pT1-pT4 (p = 0.025), grade 3 (p = 0.003) and all tumors (p = 0.001). The specificity of cytology and FISH among patients without cystoscopic evidence of urothelial carcinoma and no history of urothelial carcinoma was 98% and 96%, respectively (p = 0.564).Conclusions: The sensitivity of FISH for the detection of urothelial carcinoma is superior to that of cytology, and the specificity of FISH and cytology for urothelial carcinoma are not significantly different. Further prospective studies are required but FISH has the potential to improve significantly the management of urothelial carcinoma.