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01-09-2014 | Urology - Original Paper

FISH analysis of washing urine from the upper urinary tract for the detection of urothelial cancers

Authors: Torsten Gruschwitz, Mieczyslaw Gajda, Astrid Enkelmann, Marc-Oliver Grimm, Heiko Wunderlich, Marcus Horstmann, Kerstin Junker

Published in: International Urology and Nephrology | Issue 9/2014

Abstract

Introduction

To evaluate FISH analysis of washing urine from the upper urinary tract (UUT) in comparison with cytology (Cyt) for the detection of urothelial cancers.

Patients and methods

In 82 patients with symptoms or abnormalities of the UUT sampling of washing urine for FISH and Cyt and a stepwise diagnostic work-up (e.g. retrograde ureteropyelography, ureterorenoscopy and 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 for FISH and Cyt as well as its combination were determined.

Results

Urothelial cancer of the UUT was detected in 20 patients. Eleven patients underwent nephroureterectomy, six partial ureterectomy and three endoscopic tumour treatment. This revealed nine pTa, three pT1 and seven muscle-invasive tumours. Twelve tumours were classified as low and seven as high-grade tumours. In one patient with a macroscopic unequivocal finding of tumour, endoscopic laser ablation without histologic confirmation was performed. FISH was evaluable in 76 patients and detected 16 tumours with a sensitivity and specificity of 84.2 and 91.1 %, respectively. Cyt was performed in 79 and was evaluable in 78 patients. It detected ten tumours with a sensitivity and specificity of 52.6 and 91.4 %, respectively. Cyt and FISH together detected 19 tumours with (sensitivity 100 % and specificity 83.6 %).

Conclusion

FISH was more sensitive than and equally specific to Cyt in the detection of urothelial cancers of the UUT. Both markers in combination revealed the best sensitivity, making it a possible approach in future settings.

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Title: FISH analysis of washing urine from the upper urinary tract for the detection of urothelial cancers
Authors: Torsten Gruschwitz
Mieczyslaw Gajda
Astrid Enkelmann
Marc-Oliver Grimm
Heiko Wunderlich
Marcus Horstmann
Kerstin Junker
Publication date: 01-09-2014
Publisher: Springer Netherlands
Published in: International Urology and Nephrology / Issue 9/2014
Print ISSN: 0301-1623
Electronic ISSN: 1573-2584
DOI: https://doi.org/10.1007/s11255-014-0714-1

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