689 FISH ANALYSIS OF WASHING URINE FROM THE UPPER URINARY TRACT IN THE DETECTION OF CORRESPONDING UROTHELIAL CANCERS

Abstract

You have accessJournal of UrologyUrothelial Cancer: upper Tract Tumors (I)1 Apr 2013689 FISH ANALYSIS OF WASHING URINE FROM THE UPPER URINARY TRACT IN THE DETECTION OF CORRESPONDING UROTHELIAL CANCERS Torsten Gruschwitz, Marcus Horstmann, Mieczyslaw Gajda, Marc-Oliver Grimm, and Kerstin Junker Torsten GruschwitzTorsten Gruschwitz Jena, Germany More articles by this author , Marcus HorstmannMarcus Horstmann Jena, Germany More articles by this author , Mieczyslaw GajdaMieczyslaw Gajda Jena, Germany More articles by this author , Marc-Oliver GrimmMarc-Oliver Grimm Jena, Germany More articles by this author , and Kerstin JunkerKerstin Junker Homburg/Saar, Germany More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.245AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Fluorescence In Situ Hybridization (FISH) is approved for diagnosis and follow-up of patients with bladder cancer. Earlier studies have shown similarities between genetic alterations of urothelial cancer cells of the bladder and the upper urinary tract (UUT) The diagnostic value of FISH, however, in the detection of upper urinary tract transitional cell carcinoma (UUT TCC) remains under evaluation. METHODS In 79 consecutive patients potentially harbouring UUT TCC, sampling of ureteral washing urine for FISH and cytology, retrograde ureteropyelography, ureterorenoscopy (URS) with or without 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 were determined for FISH and cytology according to endoscopic findings and histological results. RESULTS UUT TCC was found in 17 patients. 10 patients underwent nephroureterectomy, 4 partial ureterectomy and 2 endoscopic tumour ablation. One patient is still waiting for definitive surgery. Until now histological evaluation of these patients revealed 8x pTaG1-2, 3x pT1G1-3, 4x pT3G1-3 and 1x pT4G3 tumours. FISH detected 15 out of 17 tumours and was negative in 54 patients. Cytology was positive in 9 tumour patients and negative in 50 patients. This resulted in a sensitivity and specificity for FISH of 88.2% and 87.1%, and for cytology of 53% and 74 %, respectively. CONCLUSIONS In the present study, FISH revealed to be a more sensitive and more specific marker in ureteral washing urine than cytology, which is the current reference standard in the detection of UUT TCC. Because of its high accuracy FISH positive ureteral washing urine should be considered a reason to further investigate the corresponding UUT. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e283 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Torsten Gruschwitz Jena, Germany More articles by this author Marcus Horstmann Jena, Germany More articles by this author Mieczyslaw Gajda Jena, Germany More articles by this author Marc-Oliver Grimm Jena, Germany More articles by this author Kerstin Junker Homburg/Saar, Germany More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...