Positive urinary fluorescence in situ hybridization indicates poor prognosis in patients with upper tract urothelial carcinoma.

Bao Guan,Liqun Zhou,Dong Fang,Zhenpeng Cao,Ding Peng,Qun He,Shiming He,Yonghao Zhan,Yicong Du,Gengyan Xiong,Yifan Li,Xuesong Li,Xiaohong Su,Yi Ding,Yanqing Gong

doi:10.18632/oncotarget.24007

Bao Guan, Liqun Zhou + Show 13 more

Open Access

https://doi.org/10.18632/oncotarget.24007

Copy DOI

Journal: Oncotarget	Publication Date: Jan 4, 2018
Citations: 5	License type: cc-by

Affiliation: Peking University First Hospital

Abstract

Here, we evaluated the potential contribution of fluorescent in situ hybridization (FISH) as a prognostic risk factor of bladder recurrence and survival in patients with upper tract urothelial carcinoma (UTUC). A total of 159 UTUC patients were enrolled in this study from January 2012 to May 2016. The 159 voided urine samples before surgery were analyzed using the UroVysion® kit to detect the copy numbers of chromosomes 3, 7, 17 and 9p21 (p16). Patients were classified using an optimal cutoff value of chromosomes 3, 7, 17, and 9p21. Cox's proportional hazards regression model was used to assess the prognostic value of FISH for bladder recurrence and survival. We found that 27 (17.6%) patients experienced bladder recurrence and 26 (16.4%) patients died from cancer, with a median follow-up of 27 months. The patients with positive FISH result were more likely to present bladder recurrence (p = 0.077). However, positive FISH was not associated with cancer specific-free survival (CSS) (p = 0.944). Tumor multifocality, the percentage of abnormal chromosome 3 > 5%, chromosome 7 > 6%, chromosome 17 > 11% and deletion of p16 > 4% were significant prognostic risk factors for BRFS in univariate analysis. In multivariate analysis, only tumor multifocality (hazard ratio [HR] = 3.487, 95%CI: 1.605–7.576, p = 0.002) and the percentage of p16 loss > 4% were both prognostic risk factors for bladder recurrence (HR = 3.487, 95%CI: 1.605–7.576, p = 0.002). These data consider that the urinary FISH test could be a powerful tool in predicting the risk of bladder recurrence in patients with UTUC.

Highlights

Upper tract urothelial carcinoma (UTUC) is a relatively uncommon malignant tumor [1]
About 15–25% of bladder lesions are muscle invasive, while 60% of upper tract urothelial carcinoma (UTUC) are invasive at initial diagnosis as well as patients with UTUC had comparatively poor prognosis [12]
Several studies had demonstrated that ureteroscopy increased the risk of bladder recurrence [17, 18], but urinary markers which could predict tumor recurrence were relatively few

Summary

Introduction

Upper tract urothelial carcinoma (UTUC) is a relatively uncommon malignant tumor [1]. Fluorescence in situ hybridization (FISH) analysis which uses nucleic acid probes marked with fluorescence to evaluate cells in the voided urine for chromosomal alterations and be widely applied to the field of cancer diagnosis. [4,5,6,7], and we had identified its high sensibility and prediction for advanced UTUC [8]. Several studies had reported that FISH could be used as an aid to predict prognosis in bladder cancer patients [9,10,11], but its prognostic value had not yet been confirmed in UTUC patients.

Methods

Results

Conclusion