MP36-07 ARRAY-COMPARATIVE GENOMIC HYBRIDIZATION (ACGH)-BASED ALGORITHM FOR RENAL TUMOR SUBTYPING IN NEEDLE BIOPSIES

Abstract

You have accessJournal of UrologyKidney Cancer: Evalution/Staging III1 Apr 2014MP36-07 ARRAY-COMPARATIVE GENOMIC HYBRIDIZATION (ACGH)-BASED ALGORITHM FOR RENAL TUMOR SUBTYPING IN NEEDLE BIOPSIES Massimiliano Spaliviero, Banumathy Gowrishankar, Jeremy C. Durack, Kelly L. Stratton, Charles Ma, Timothy F. Donahue, Alexandra E. Arndt, Nicole E. Benfante, Stephen B. Solomon, Jane Houldswoth, and Jonathan A. Coleman Massimiliano SpalivieroMassimiliano Spaliviero More articles by this author , Banumathy GowrishankarBanumathy Gowrishankar More articles by this author , Jeremy C. DurackJeremy C. Durack More articles by this author , Kelly L. StrattonKelly L. Stratton More articles by this author , Charles MaCharles Ma More articles by this author , Timothy F. DonahueTimothy F. Donahue More articles by this author , Alexandra E. ArndtAlexandra E. Arndt More articles by this author , Nicole E. BenfanteNicole E. Benfante More articles by this author , Stephen B. SolomonStephen B. Solomon More articles by this author , Jane HouldswothJane Houldswoth More articles by this author , and Jonathan A. ColemanJonathan A. Coleman More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1071AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Image-guided needle biopsy is increasingly used in the pre-surgical evaluation and clinical management of renal masses although definitive histologic diagnosis may remain challenging, especially in small renal tumors. The aim of this study was the development of a molecular assay to augment biopsy histology in subtyping renal cortical neoplasms. METHODS Following IRB approval, a prospective, single-blinded study was conducted in 40 patients undergoing image-guided biopsies of renal masses. A total of 44 needle biopsies were obtained; 5 biopsies were excluded due to incomplete clinical data or the cystic nature of the mass. DNA extracted from 39 biopsies was subjected to array comparative genomic hybridization (aCGH) using a targeted oligonucleotide microarray representing genomic regions commonly altered in renal neoplasms. Detected genomic alterations were used to assign a renal tumor subtype per a decision tree algorithm developed from TCGA copy number dataset, in-house FISH studies, and published literature. Renal tumor subtype obtained by aCGH was compared with biopsy histology or surgical specimen (when available). RESULTS Histology interpretation from 39 core biopsies called malignant subtypes in 29 (12 clear cell [ccRCC], 10 papillary [pRCC], 2 chromophobe [chrRCC], 2 unclassified, and 3 poorly differentiated RCC], benign lesions in 5 (including 3 AML and 2 oncocytoma), low grade oncocytic neoplasms in 3, and non-diagnostic in 2 specimens. Three specimens were non-diagnostic by aCGH. Evaluation of concordance between aCGH algorithm performance and histology was feasible for 28 specimens owing to availability of histologic tissue diagnosis and specimen sufficiency. Among the 28 specimens, 23 of 28 (82%) were concordant by aCGH. aCGH correctly correlated with benign histology in 5 of 6 biopsies. Two of the 3 low-grade oncocytic lesions, which may have low malignant potential, showed clonal genomic alterations associated with a malignant subtype. aCGH provided subtype classification in 2 unclassified biopsy specimens, one of which was confirmed as concordant with the ccRCC histology at nephrectomy. CONCLUSIONS In this preliminary study, genomic alterations in renal neoplasms are detectable by aCGH from percutaneous biopsy material in over 90% of specimens. Using algorithm-based assignment, concordance with needle biopsy histology was over 80% and the sole means of correct diagnosis in isolated cases. Genomic-based platforms have the potential to play a significant role in augmenting histopathology findings from core biopsy. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e381 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Massimiliano Spaliviero More articles by this author Banumathy Gowrishankar More articles by this author Jeremy C. Durack More articles by this author Kelly L. Stratton More articles by this author Charles Ma More articles by this author Timothy F. Donahue More articles by this author Alexandra E. Arndt More articles by this author Nicole E. Benfante More articles by this author Stephen B. Solomon More articles by this author Jane Houldswoth More articles by this author Jonathan A. Coleman More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...