Evaluation of urovysion and cytology for bladder cancer detection: a study of 1835 paired urine samples with clinical and histologic correlation.
Evaluation of urovysion and cytology for bladder cancer detection: a study of 1835 paired urine samples with clinical and histologic correlation.
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DOI：
10.1002/cncy.21327
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发表时间：
2013-10
影响因子：
3.4
通讯作者：
Yang, Jack
中科院分区：
文献类型：
--
作者：
Dimashkieh, Haythem;Wolff, Daynna J.;Smith, T. Michael;Houser, Patricia M.;Nietert, Paul J.;Yang, Jack
尿细胞学已被用于筛查膀胱癌，但受到其低灵敏度的限制。UroVysion是一种FISH检测试剂盒，可检测膀胱癌中常见的染色体异常。本研究评价了UroVysion和尿细胞学在同一尿样中检测尿路上皮细胞癌（UCC）的有效性。选择了符合以下标准的1，835例病例：来自同一尿液样本的UroVysion和细胞学检查的有效结果;原始检查后4个月内的组织学和/或膀胱镜随访，或至少3年的临床随访信息。UroVysion和细胞学检查结果与结合组织学、膀胱镜检查和临床随访信息得出的临床结局相关。1,835例中，监测UCC复发1,045例，血尿790例。UroVysion检测UCC的总体敏感性、特异性、PPV和NPV分别为61.9%、89.7%、53.9%和92.4%，细胞学检测分别为29.1%、96.9%、64.4%和87.5%。在监测人群和高级别UCC样本中，UroVysion和细胞学检查的性能通常更好。在95/296例非典型细胞学证实为UCC的病例中，61例（大多数为高级别UCC）UroVysion阳性。UroVysion检测UCC的敏感性高于细胞学，但假阳性率较高。我们的数据表明，在可疑的细胞学诊断后使用UroVysion作为反射检测可能对UCC检测起有效作用。
Urine cytology has been used for screening of bladder cancer but has been limited by its low sensitivity. UroVysion is a FISH assay that detects common chromosome abnormalities in bladder cancers. The present study evaluates the effectiveness of UroVysion and urine cytology in detecting urothelial cell carcinoma (UCC) in same urine sample. 1,835 cases with the following criteria were selected: valid results of both UroVysion and cytology from same urine sample; histological and/or cystoscopic follow up within 4 months of the original tests, or at least 3 year clinical follow up information. The results of the UroVysion and cytology were correlated with clinical outcome that was derived from combination of histological, cystoscopic and clinical follow up information. Of 1,835 cases, 1,045 cases were for surveillance of recurrent UCC, 790 cases were for hematuria. Overall sensitivity, specificity, PPV and NPV in detecting UCC were 61.9%, 89.7%, 53.9% and 92.4%, respectively for UroVysion, and 29.1%, 96.9%, 64.4% and 87.5%, respectively for cytology. The performance of both UroVysion and cytology was generally better in the surveillance population and in samples with high grade UCC. In 95 of 296 cases with atypical cytology that were proven to have UCC, 61 cases, mostly high grade UCC, were positive for UroVysion. UroVysion was more sensitive than cytology in detecting UCC, but produced more false positive result. Our data suggest that the use of UroVysion as a reflex test following an equivocal cytological diagnosis may play an effective role for UCC detection.
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