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741 Does hexaminolevulinate detect chromosomal aberrations in the false-positive bladder biopsies?
741
Does hexaminolevulinate detect chromosomal aberrations in the false-positive bladder biopsies? Eur Urol Suppl 2016;15(3);e741
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D'Andrea D.1 , Martini T.2 , Mian C.3 , Palermo S.M.1 , Comploj E. 1 , Pycha A. 1 1 General
Hospital of Bolzano, Dept. of Urology, Bolzano, Italy, 2 Ulm University Medical Center, Dept. of Urology, Ulm, Germany, 3 General
Hospital of Bolzano, Dept. of Pathology, Bolzano, Italy INTRODUCTION & OBJECTIVES: With the introduction of photosensitizing drugs allowing Photodynamic Diagnostic (PDD) the detection of bladder cancer has become more accurate. The main limitation of the procedure is the false-positive detection rate, which ranges from 12% to 60%. The onset of multifocal transitional cell carcinoma has been described as a panurothelial disease as it evolves because of genetic defects that are present also in histological negative urothelial tissue. We analyzed chromosomal patterns of false-positive lesions in the PDD and compared them with the findings of random biopsies with the intent to observe if the hexaminolevulinate detects chromosomal aberration in histological healthy tissue. MATERIAL & METHODS: Included in the study were 48 patients, with suspected flat urothelial lesion on cistocopy or cytology. All patients received an intravescical instillation of 80mg HAL (Hexvix®, Photocure ASA). The bladder was inspected under white and blue light. All cancer suspicious areas were biopsied. In the case of PDD positivity a random sample was taken and the chromosomal pattern of all biopsies was analyzed with Fluorescence In Situ Hybridization (FISH; UroVysion® Bladder Cancer Kit, Abbott Molecular). RESULTS: 153 of 251 biopsies in 40 patients could be evaluated for FISH analysis. 45 biopsies in 22 patients were PDD positive but negative in white light and histology (false-positive biopsies). 9 Out of 22 patients showed chromosomal aberration in 12 (26,7%) of the false-positive biopsies. All biopsies showed aneusomy of the Locus 9p21 (p16), 8 (17,8%) also aneusomy of chromosome 3 and 7 biopsies (15,5%) also aneusomy of chromosome 7 and chromosome 17. In 7 patients the FISH of the control random biopsy was positive. 6 had an aneusomy of Locus 9p21 (p16), 4 had aneusomy also for chromosome 3, 7 and 17 and one had aneusomy of chromosome 17 only. CONCLUSIONS: In our trial over a third of the patients with a false-positive PDD finding already express chromosomal aberrations in these lesions.
Does hexaminolevulinate detect chromosomal aberrations in the false-positive bladder biopsies? Eur Urol Suppl 2016;15(3);e741
Print! Print!
D'Andrea D.1 , Martini T.2 , Mian C.3 , Palermo S.M.1 , Comploj E. 1 , Pycha A. 1 1 General
Hospital of Bolzano, Dept. of Urology, Bolzano, Italy, 2 Ulm University Medical Center, Dept. of Urology, Ulm, Germany, 3 General
Hospital of Bolzano, Dept. of Pathology, Bolzano, Italy INTRODUCTION & OBJECTIVES: With the introduction of photosensitizing drugs allowing Photodynamic Diagnostic (PDD) the detection of bladder cancer has become more accurate. The main limitation of the procedure is the false-positive detection rate, which ranges from 12% to 60%. The onset of multifocal transitional cell carcinoma has been described as a panurothelial disease as it evolves because of genetic defects that are present also in histological negative urothelial tissue. We analyzed chromosomal patterns of false-positive lesions in the PDD and compared them with the findings of random biopsies with the intent to observe if the hexaminolevulinate detects chromosomal aberration in histological healthy tissue. MATERIAL & METHODS: Included in the study were 48 patients, with suspected flat urothelial lesion on cistocopy or cytology. All patients received an intravescical instillation of 80mg HAL (Hexvix®, Photocure ASA). The bladder was inspected under white and blue light. All cancer suspicious areas were biopsied. In the case of PDD positivity a random sample was taken and the chromosomal pattern of all biopsies was analyzed with Fluorescence In Situ Hybridization (FISH; UroVysion® Bladder Cancer Kit, Abbott Molecular). RESULTS: 153 of 251 biopsies in 40 patients could be evaluated for FISH analysis. 45 biopsies in 22 patients were PDD positive but negative in white light and histology (false-positive biopsies). 9 Out of 22 patients showed chromosomal aberration in 12 (26,7%) of the false-positive biopsies. All biopsies showed aneusomy of the Locus 9p21 (p16), 8 (17,8%) also aneusomy of chromosome 3 and 7 biopsies (15,5%) also aneusomy of chromosome 7 and chromosome 17. In 7 patients the FISH of the control random biopsy was positive. 6 had an aneusomy of Locus 9p21 (p16), 4 had aneusomy also for chromosome 3, 7 and 17 and one had aneusomy of chromosome 17 only. CONCLUSIONS: In our trial over a third of the patients with a false-positive PDD finding already express chromosomal aberrations in these lesions.