Utility of Fluorescent In Situ Hybridization in Addition to Voided Urine Cytology in The Diagnostic Work Up of Bladder Cancer Patients: A Pilot Study from A South Indian Referral Laboratory
Journal Title: Journal of Urology & Nephrology - Year 2018, Vol 5, Issue 1
Abstract
Background: Bladder cancer (BC) is amongst the most prevalent cancers associated with urinary tract. Although voided urine cytology (VUC) is currently an important urine-based laboratory test, it falls short due to high rate of false negative and equivocal diagnosis. Inter observer, intra observer and institutional variability have been few of the technical facets of cytology. Fluorescent In Situ Hybridization (FISH) has proven to be more sensitive and specific than VUC, with gradual improvement in higher grade tumours. This pilot study was conducted to evaluate the diagnostic yield of FISH on voided urine samples in correlation with cytology from patients suspected of and under surveillance for BC in an Indian population. Materials and methods: VUC and Bladder cancer FISH (Aquarius probes, Cytocell, UK) was performed on 24 urine samples from patients suspected of and under surveillance for BC. Findings were reported as per Paris System of Urinary Cytology and International System of Cytogenomic Nomenclature. Results: FISH was positive in 8 patients (33%) while cytology was positive only in 4 patients (16%). Positivity increased to 41% (10 cases) when both techniques were combined. In our study, positive cases included 4 cases of polysomy, 3 cases of homozygous deletion of P16 and an isolated case of trisomy 3. Conclusion: Interphase FISH is a fast, easy, and reliable test in identifying specific genetic aberrations in BC. When coupled with VUC, it increases the diagnostic yield in a routine diagnostic setup. It is important to implement molecular tests in the diagnostic work up of BC patients for effective diagnosis and management.
Authors and Affiliations
Vishal Ashok
Keywords
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- EP ID EP496725
- DOI 10.13188/2380-0585.1000023
- Views 112
- Downloads 0
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