Usefulness of the UBCTM (urinary bladder cancer) test compared to urinary cytology for transitional cell carcinoma of the bladder in patients with hematuria

306

305 DETECTION OF GENETIC ALTERATIONS AT CHROMOSOMES 3,7, 9P21, AND 17 WITH MULTITARGET FISH IN BLADDER WASHINGS AS NONINVASIVE DIAGNOSTIC TOOL FOR BLADDER CANCER

UROVYSION FISH ASSAY FOR NON-INVASIVE BLADDER TUMORS IN URINARY SPECIMENS

Toma Marie&

Guide’ , Dalquen Peter’

Bubendorf Friedrich Martin, Hautmann

Urology, University

Hospital Hamburg,

Stefan, Huland Hartwig

Hamburg.

Germany

Grilli Bruno’, Mihatsch

Lukas’ , Gasser Thomas’.

‘Pathology,

University,

Basel.

DETECTION

‘Urology,

Switzerland,

OF

Michael’,

University,

Sauter

Liestal,

Switzerland

INTRODUCTION & OBJECTIVES: Detection of genetic alterations in urine specimens is a promising tool for non-invasive detection of bladder cancer. We investigated aneuploidy at chromosomes 3, 7, I7 such as loss of 9~21 using a multitarget fluorescence in situ hybridisation (FISH. Urovision, Vysis). The results of the FISH analysis were compared with other non-invasive tests such as BTAstat, NMP22, immunocytology with the monoclonal antibodies LewisX and 486~3112, MATERIALS & METHODS: Urine samples from 98 patients were included into the study. 45 patients had histologically confirmed TCC, 2 patients had other urological malignancies, urine samples of 55 patients served as control. Urine samples were taken before any manipulation. Evaluation of the tests was blinded to clinical and pathological data. Thresholds were IOU/ml NMP22, 5% positive cells (LewisX), and 30% positive cells (486~3112). RESULTS: Sensitivity was 68.8% (FISH), 66.6% (BTAstat). 68.8%, (486~3112). 95.5% (LewisX), and 71 .I I% (NMP22) respectively. Specificity was 89.1% (FISH), 78.2% (BTAstat). 76.4% (486p3/12), 32.8% (LewisX), and 65.45% (NMP22) respectively. The positive predictive value was 83.8% (FISH), 71,42% (BTAstat), 70.45% (486p3/12),52.4% (LewisX), and 62.74% (NMP22) respectively. The negative predictive value was 77.8% (FISH), 75.43% (BTAstat). 75% (486~3112). 9071 (LewisX). and 73.47% (NMP22) respectively. CONCLUSION: Multitarget FlSH showed higher sensitivity and specificity than other non-invasive urine tests. Therefore it seems to be a useful marker for surveillance of patients with a history of bladder carcinoma.

CONSERVATIVE THE DIAGNOSIS Stenos Loukas’. Stenos John’

URINE CYTOLOGY vs THIN-PREP OF BLADDER CANCER

Politi Ekaterini’.

Thomopoulou

‘Elpis Hospital, Athens, Greece. ‘Areteion

Georgia’.

MATERIALS & METHODS: Three groups of specimen were examined: I) 27 voided urines from patients with TUR-P for benign prostatic hyperplasia (BPH) to be used as controls. II) 70 voided urine collected prior to resection of bladder cancer. III) IO voided urines from cystoscopically negative bladders of patients with a history of bladder cancer. The UroVysion multicolour FISH probe (Vysis Inc.. Downers Grove, IL) was applied for the detection of copy number aberration of chromosomes 3,7, I7 and 9~21. FISH positivity was defined as >2 urothelial cells with an abnormal signal copy number. RESULTS: Standard cytology was positive in 3 of 27 urine from BPH patients and detected 24% of the 45 non-invasive (pTa). 50% of the 12 pTI and 85% of the I3 pT2-4 bladder cancera. FISH was positive in only 1 of 27 BPH control urine but detected 737~ of the pTa and 100% of both pTl and pT2-4 turnours. In addition, FISH was positive in 5 of IO patients without visible tumour at the time of follow-up cystoscopy. Subsequent recurrence was found in 4 of these 5 patients, but in none of the 5 FISH negative patients (p
307

308

IN

USEFULNESS OF THE UBCTM (URINARY BLADDER CANCER) TEST COMPARED TO URINARY CYTOLOGY FOR TRANSITIONAL CELL CARCINOMA OF THE BLADDER IN PATIENTS WITH HEMATURIA

METHOD

Koutselini

INTRODUCTION & OBJECTIVES: The objective of this study was to evaluate multicolour fluorescence in situ hybridisation (FISH) for improved non-invasive detection of bladder cancer in urinary specimens.

Eleni’.

Junrr

Hospital, Athens, Greece

Se-il.

INTRODUCTION & OBJECTIVES: In the past few years a great effort is ongoing to find new bladder cancer markers or to improve the already existing examinations such as urine cytology, in order to achieve early diagnosis of the bladder cancer but also easier monitoring of the patients by avoiding aggressive methods such as cystoscopy. In our study we compare the conservative method of urine cytology with the new method THIN-PREP. MATERIALS & METHODS: We studied 42 patients classified by stage and grade. From each one of them we took three morning samples of urine in three different days and we compared them with one urine sample that was placed in the THIN-PREP processor. The last is a slide preparation device that automatically filters cells out of the suspension and transfers a 20.mm-diameter cell sample onto a microscope slide.

Department

methods

bladder

cancer

study.

according

method

was

method.

In

(68%)

positive grade

II

013

(0%)

instead

cancers

respectively.

conservative PREP

in

I tumours

Finally

method

were

the

positive

in

grade

9113

(69%)

of

the

conservative

I13

results

(33%) were

111 tumours imtead

of

the

of 5119

urine the

THIN-PREP

(26%)

and

positive

II113 (84%)

cytology

results with

13119 for

the

had

diagnosi\

various

levels were

(I 7119)

in UBC

test was only

test wa\

negative.

more sensitive

in grade

I (83.3%vs 16.7%.

CONCLUSION: Comparing our results we found a clear superiority of the THIN-PREP method in all grades and stages except the stage T3 where the two method\ were equal. So we confirm that the THIN-PREP method i\ a

be more

sensitive

preparation

CONCLUSION:

decreasing stages

helpful

method diagnosis

of

which

the number neoplasms.

in the early

provide5

by minimising

high

cell

of false-negative

We conclude diagnosis

quality

cytological

loss, preserving samples

especially

that the THIN-PREP

of bladder

cancer.

specimens

morphological in lower

for

an

details

and

grades

and

method can be very

in Grade

other

valuable with

in UBCTM

povitlve urinary

and urinary

in stage Ta, TI

p
(83.3%

group

Other

Samples

wcrc

A (95.9kl66.4

(~~0.05).

(84.6

(65165)

for

in cytology.

was negative.

test

~~0.05)

test showed in Grade

In 2

UBCTM

vs 38.5%.

1.90%

of TCC

Specificity

negative.

also

UBCTM

in Grade

A).

for diagnosis

cytology

wa5

turnours

than cytology.

as grade was higher

between

in

urine as TCC

(Group

12 IdgiL.

test and 100%

cytology

confirmed

than

in cytology

included

and

tendency

to

II and 100%

III).

benign

compared

(53165)

(9119)

were

B).

Sensitivity

of

test.

(Group

was greater different

were

test

epithelium

in mid-stream

resection

conditions

related

test and urinary

hematuria

assayed

are

UBCTM

from

UBCTM

patients

exam

imprecision

of UBCTM

with

Korea

But the former

method.

released

tranrureteral

(p
test and 37.4%

and wide

were

Nineteen

significantly pg/L)

was 8 1.5%

UBCTM

patients

tract

(TCC).

is an invasive

We compared

concentration

B (19.2*X5.6

of TCC

In X ca\e\,

urinary

UBC

was significantly

method.

accurate

Yoon

South

and cystoscopic

the usefulness

and underwent

Pusan.

Carcinoma

examiner

Sweden)

assay protocol.

benign

cytology

fragments

assay.

Biotech,

as the UBC

cakes UBCTM

the THIN-

cytokeratin

of Medicine.

Cell

the latter

Eighty-four

test (IDL

examination

and group 89.5%

Urinary

to evaluate

positive

RESULTS: ~15

of TCC

to the ordinary

patients

exam,

& METHODS:

UBCTM

by cystoscopic

School

of Transitional

by immunoradiometric

MATERIALS our

University

on specific

for diagnosis

/‘g/L)

grade

Rha Seo Hee, Seong You1 Koon.

such as need of well-trained

the epitope

were

For

Do Young,

& OBJECTIVES:

of microscopic

detects cytology

Dong-A

for diagnosis

qhows drawbacks to variability

considered

313 (100%).

of Urology.

INTRODUCTION effective

RESULTS: In stage Ta neoplasms the conservative urine cytology method was positive in 4116 patients (25%), instead of 9/16 patients (56%) of the THINPREP method. In Tl stage turnours the positive results were h/l I (54%) and IO/l I (90%) respectively. In stage T2 neoplasms the positive results were 7112 (58%) and 8/12 (66%) respectively. Finally in stage T3 cancers the two methods equal:

Myung Cheol, Kang

Gil

Jin Han

UBCTM

marker

cytology.

is helpful

be a useful

method

Moreover.

UBCTM

test

in patients

with

TCC

disease.

for diagnosis

to urinary

cytology

test could

genitourinury

ofTCC Therefore

to overcome

European

combined

limited

Urology

in distinguishing

early

use of UBCTM

sensitivity

Supplements

could of low

TCC

from

be especially graded

TCC

test in association

of cytology. 1 (2002) No. 1, pp. 79