MP69-19 EFFICACY OF FISH ANALYSIS ON URINARY SPECIMENS DURING ENDOSCOPIC MANAGEMENT OF UPPER TRACT UROTHELIAL CARCINOMA

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP69-19 EFFICACY OF FISH ANALYSIS ON URINARY SPECIMENS DURING ENDOSCOPIC MANAGEMENT OF UPPER TRACT UROTHELIAL CARCINOMA Orel Carmona, Nir Kleinmann, Dorit E. Zilberman, Zohar A. Dotan, and Asaf Shvero Orel CarmonaOrel Carmona More articles by this author , Nir KleinmannNir Kleinmann More articles by this author , Dorit E. ZilbermanDorit E. Zilberman More articles by this author , Zohar A. DotanZohar A. Dotan More articles by this author , and Asaf ShveroAsaf Shvero More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003332.19AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: FISH analysis (Fluorescence in-situ hybridization) is a laboratory technique used to detect chromosomal aberrations typical to malignant cells in body fluids. The EAU and NCCN guidelines on the management of upper tract urothelial carcinoma (UTUC) do not include recommendations relating to FISH analysis as part of the follow-up regimen of UTUC. The objective of this study was to examine the efficacy of FISH analysis on selective urine samples of patients undergoing endoscopic management for UTUC. METHODS: The medical records of all patients who managed endoscopically for UTUC at our institute between 2014-2022 were retrospectively analyzed. Demographic and clinical data, histology, cytology, and FISH results were collected. FISH analysis was considered malignant if It showed more than 4 cells with hyperploidy of chromosomes 3, 7, 17 or more than 12 cells with deletion of 9p21 locus on chromosome 9. RESULTS: During the study period, 62 patients underwent 561 ureteroscopies as part of the treatment and follow-up of UTUC. Cytology and FISH tests were performed in 376 and 273 cases, respectively. In 206 (75.4% of FISH studies) the FISH analysis was different from the cytology results: Out of the 58 cases found as benign in a cytology test, FISH analysis showed chromosomal aberrations in 9 (15.5%) cases. In all the 197 cases that a cytology test reported atypia, FISH analysis successfully classified the cells as benign (93 cases, 47.2%) or malignant (104 cases, 52.8%). Table 1 demonstrates the difference between cytology and FISH results in 133 cases in which the ureteroscopy showed no suspicious lesions, and both cytology and FISH analysis was performed. Out of the 217 endoscopies that resulted in biopsy-proven UTUC, cytology was taken in 143 cases and demonstrated malignant cells in 10 (7%) cases and atypical cells in 97 (67.8%) cases. FISH analysis was performed on 108 of these samples and successfully classified the cells as malignant in 59 (54.6%) cases. CONCLUSIONS: FISH analysis should be a part of the follow-up regimen of patients undergoing endoscopic management for UTUC. When cytology reported cellular atypia, FISH analysis successfully classified the cells as malignant or benign in all cases. There is an added value to perform FISH analysis when cytology test was performed. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e972 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Orel Carmona More articles by this author Nir Kleinmann More articles by this author Dorit E. Zilberman More articles by this author Zohar A. Dotan More articles by this author Asaf Shvero More articles by this author Expand All Advertisement PDF downloadLoading ...