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749 Diagnostic utility of UroVysion for urothelial carcinoma of the upper urinary tract
749
Diagnostic utility of UroVysion for urothelial carcinoma of the upper urinary tract Eur Urol Suppl 2016;15(3);e749
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Sassa N.1 , Tsuzuki T.2 , Hattori R.3 , Kato M. 1 , Ishida S. 1 , Sano T.3 , Gotoh M. 1 , Tokai Urological Study Group 1 Nagoya
University, Dept. of Urology, Nagoya, Japan, 2 Japanese Red Cross Nagoya Daini Hospital, Dept. of Pathology, Nagoya, Japan,
3 Japanese
Red Cross Nagoya Daiichi Hospital, Dept. of Urology, Nagoya, Japan
INTRODUCTION & OBJECTIVES: Diagnosis of urothelial carcinoma of the upper urinary tract (UCUUT) is critical. However, only few tools are available for accurate and safe diagnosis. This study aimed to determine the usefulness of UroVysion in the examination of urine cytology specimens. MATERIAL & METHODS: We prospectively enrolled 44 consecutive patients who were referred at the authors’ hospitals with suspected UCUUT between 2014 and 2015. As controls, 20 patients without UCUUT were also enrolled. Selected washed or voided urine samples from the patients and controls were evaluated using a liquid-based cytological test (ThinPrep) and UroVysion. The analyses were performed using the Metafer-Metacyte slide scanning system. At least 25 cells were analyzed for each case. Results from UroVysion were considered positive if (i) ≥ 10% cells had polysomy of three chromosomes; (ii) ≥ 10% cells had polysomy of two chromosomes and deletion of 9p21; or (iii) ≥ 30% cells had deletion of 9p21. All the samples were also evaluated by using the Paris system (TPS). The patients’ characteristic and FISH data were analyzed by using the Fisher exact test. RESULTS: The results are shown in Tables 1 and 2. 9 cases diagnosed as atypical cell and 4 cases diagnosed as suspicious for high grade urothelial carcinoma (UC) by TPS were diagnosed as positive by UroVysion, respectively. A IgG4-related disease was diagnosed as positive by UroVysion, which was diagnosed as suspicious for high grade UC by TPS. Three normal control cases was diagnosed as positive by UroVysion, which was diagnosed as negative for high grade UC by TPS.
Table 1: Case characteristics FISH and pathological data Unsatisfactory Negative Positive Total High grade UC 4 10 24 38 Low grade UC 0 3 0 3 RCC 1 0 0 1 IgG4 related 0 0 1 1 Hematoma 0 1 0 1 Negative control 0 17 3 20 UC: Urothelial carcinoma, RCC: Renal cell carcinoma
UC: Urothelial carcinoma, RCC: Renal cell carcinoma
Table 2: Comparison between UroVysion and cytology by TPS UroVysion Cytology (TPS) p value Sensitivity 63.2% (24/38) 39.5% (15/38) .039 Specificity 82.6% (19/23) 100% (23/23) .019 Positive predictive value 85.7% (24/28) 100% (15/15) .124 Negative predictive value 57.6% (19/33) 50.0% (23/46) .506
※Fisher‘s test ; Significant, p<.05 CONCLUSIONS: The results indicate that UroVysion can be a useful ancillary method to diagnose UCUUT.
Diagnostic utility of UroVysion for urothelial carcinoma of the upper urinary tract Eur Urol Suppl 2016;15(3);e749
Print! Print!
Sassa N.1 , Tsuzuki T.2 , Hattori R.3 , Kato M. 1 , Ishida S. 1 , Sano T.3 , Gotoh M. 1 , Tokai Urological Study Group 1 Nagoya
University, Dept. of Urology, Nagoya, Japan, 2 Japanese Red Cross Nagoya Daini Hospital, Dept. of Pathology, Nagoya, Japan,
3 Japanese
Red Cross Nagoya Daiichi Hospital, Dept. of Urology, Nagoya, Japan
INTRODUCTION & OBJECTIVES: Diagnosis of urothelial carcinoma of the upper urinary tract (UCUUT) is critical. However, only few tools are available for accurate and safe diagnosis. This study aimed to determine the usefulness of UroVysion in the examination of urine cytology specimens. MATERIAL & METHODS: We prospectively enrolled 44 consecutive patients who were referred at the authors’ hospitals with suspected UCUUT between 2014 and 2015. As controls, 20 patients without UCUUT were also enrolled. Selected washed or voided urine samples from the patients and controls were evaluated using a liquid-based cytological test (ThinPrep) and UroVysion. The analyses were performed using the Metafer-Metacyte slide scanning system. At least 25 cells were analyzed for each case. Results from UroVysion were considered positive if (i) ≥ 10% cells had polysomy of three chromosomes; (ii) ≥ 10% cells had polysomy of two chromosomes and deletion of 9p21; or (iii) ≥ 30% cells had deletion of 9p21. All the samples were also evaluated by using the Paris system (TPS). The patients’ characteristic and FISH data were analyzed by using the Fisher exact test. RESULTS: The results are shown in Tables 1 and 2. 9 cases diagnosed as atypical cell and 4 cases diagnosed as suspicious for high grade urothelial carcinoma (UC) by TPS were diagnosed as positive by UroVysion, respectively. A IgG4-related disease was diagnosed as positive by UroVysion, which was diagnosed as suspicious for high grade UC by TPS. Three normal control cases was diagnosed as positive by UroVysion, which was diagnosed as negative for high grade UC by TPS.
Table 1: Case characteristics FISH and pathological data Unsatisfactory Negative Positive Total High grade UC 4 10 24 38 Low grade UC 0 3 0 3 RCC 1 0 0 1 IgG4 related 0 0 1 1 Hematoma 0 1 0 1 Negative control 0 17 3 20 UC: Urothelial carcinoma, RCC: Renal cell carcinoma
UC: Urothelial carcinoma, RCC: Renal cell carcinoma
Table 2: Comparison between UroVysion and cytology by TPS UroVysion Cytology (TPS) p value Sensitivity 63.2% (24/38) 39.5% (15/38) .039 Specificity 82.6% (19/23) 100% (23/23) .019 Positive predictive value 85.7% (24/28) 100% (15/15) .124 Negative predictive value 57.6% (19/33) 50.0% (23/46) .506
※Fisher‘s test ; Significant, p<.05 CONCLUSIONS: The results indicate that UroVysion can be a useful ancillary method to diagnose UCUUT.