Clinical utility of fluorescence in situ hybridization for voided urine for the diagnosis and surveillance of bladder cancer

Abstract

Purpose: To evaluate the clinical utility of performing fluorescence in situ hybridization (FISH) in voided urine specimens for the diagnosis and surveillance of bladder cancer, we compared the results of FISH with the results of urine cytology. Materials and Methods: Voided urine samples from 196 patients were obtained for performing FISH and urine cytology. The bladder cancer group consisted of 76 patients who had biopsy-proven bladder cancer, and the control group was 120 patients without bladder cancer. FISH was performed using the UroVysion kit. The sensitivity and specificity of FISH were determined and compared with that of urine cytology. Results: The overall sensitivity for FISH was significantly higher than the corresponding value for urine cytology (50% vs. 23.7%, respectively, p= 0.001). The specificities for FISH and cytology were 97.5% and 99.2%, respectively. When analyzing the results concerning the T-category, the sensitivity of FISH and cytology was 22.9% and 8.6% for pTa, 79.2% and 45.8% for pT1, and 54.5% andl 9.1% for pT2-4 tumors, respectively. Concerning the tumor grade, the:sensitivity was 22.2% and 5.6% for G1, 48.5% and 24.2% for G2, 70.8% and 33.3% for G3 for FISH and cytology, respectively. Conclusions: These findings show that the sensitivity of FISH for voided urine samples is higher than that of cytology, but the specificity was not significantly different. We recommend FISH as a useful diagnostic tool for patients who are suspected of having new bladder cancer and recurrent cancer, in combination with performing urine cytology.