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Inicio Actas Urológicas Españolas (English Edition) Fluorescent in situ hybridization as a predictor of relapse in urothelial carcin...
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Vol. 37. Issue 7.
Pages 395-400 (July - August 2013)
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Vol. 37. Issue 7.
Pages 395-400 (July - August 2013)
Original article
Fluorescent in situ hybridization as a predictor of relapse in urothelial carcinoma
La hibridación in situ fluorescente en la predicción de recurrencia del carcinoma urotelial
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B. García-Peláeza,
Corresponding author
bgarcia@biopat.es

Corresponding author.
, I. Triasc,d, R. Romána,b, C. Pubillc, J.M. Banúse, X. Puiga,b,c
a BIOPAT, Biopatología Molecular SL, Grup Assistència, Barcelona, Spain
b Hospital de Barcelona-SCIAS, Grup Assistència, Barcelona, Spain
c Histopat Laboratoris, Barcelona, Spain
d Hospital Plató Fundació Privada, Barcelona, Spain
e Institut Català d’Urologia i Nefrologia, Barcelona, Spain
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Figures (2)
Tables (3)
Table 1. Contingency table. Global Series FISH versus cytology.
Table 2. Sensitivity of the FISH technique versus conventional cytology for the detection of urothelial carcinoma for concomitant tumors.
Table 3. Characterization of episodes of urothelial carcinoma of patients with recurrence. Distribution by grades and stages.
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Abstract
Objective

To assess the value of the study of chromosomal alterations by fluorescent in situ hybridization in a series of patients diagnosed of urothelial carcinoma and a minimum follow-up of twenty-four months, as well as evaluate its putative predictive potential.

Materials and methods

The overall series includes 338 samples from 98 patients with 84 episodes of urothelial carcinoma. A subgroup of 24 patients who had at least one recurrence during the follow-up was used to evaluate the predictive potential of the test. Three categories were considered (positive coherent episode, negative coherent episode, and incoherent episode) depending on the relationship between the fluorescent in situ hybridization result in the concomitant study of the new episode and those of the preceding samples.

Results

Fluorescent in situ hybridization showed higher sensitivity regardless of grade, negative predictive value and accuracy, while specificity and positive predictive value were superior with conventional cytology. In the recurrence, series 19/29 episodes were coherent, 11/19 were positive coherent with urothelial carcinoma all high grade and 8/19 negative coherent, most low grade.

Conclusions

Fluorescent in situ hybridization test shows good sensitivity during a follow-up of twenty-four months and is able to predict recurrence, especially in cases of high grade. Our data demonstrate the existence of urothelial carcinomas without detectable chromosomal abnormalities by currently available methodology. The results support a multidisciplinary follow-up combining fluorescent in situ hybridization, cytology and cystoscopy.

Keywords:
Urovysion
Urothelial carcinoma
Hybridization in situ
Cytology
Recurrence
Follow-up
Resumen
Objetivo

Evaluar la utilidad del estudio de alteraciones cromosómicas mediante hibridación in situ fluorescente en una serie de pacientes diagnosticados de carcinoma urotelial con un seguimiento mínimo de 24 meses, y analizar su posible efecto anticipador.

Material y métodos

La serie global incluye 338 muestras procedentes de 98 pacientes con 84 episodios de carcinoma urotelial. Para evaluar la capacidad de predicción del test se estudió un subgrupo de 24 pacientes que presentaron como mínimo una recurrencia a lo largo del seguimiento (serie de recurrencia). Se consideraron 3 categorías (episodio coherente positivo, episodio coherente negativo y episodio no coherente) en función de la relación entre los resultados de la hibridación in situ fluorescente del estudio concomitante al nuevo episodio y las muestras precedentes.

Resultados

La hibridación in situ fluorescente presentó mayor sensibilidad independientemente del grado, valor predictivo negativo y exactitud, mientras que la especificidad y el valor predictivo positivo fueron superiores para la citología convencional. En la serie de recurrencia 19/29 episodios resultaron coherentes, 11/19 fueron coherentes positivos, todos con carcinoma urotelial de alto grado, y 8/19 coherentes negativos, la mayoría de bajo grado.

Conclusiones

La hibridación in situ fluorescente muestra una alta sensibilidad en un seguimiento de 24 meses, y es capaz de predecir recurrencias, especialmente en casos de alto grado. Nuestros datos demuestran también la existencia de carcinomas uroteliales sin alteraciones cromosómicas detectables con la metodología actualmente disponible. Los resultados apoyan un seguimiento multidisciplinar con la utilización combinada de la hibridación in situ fluorescente, citología y cistoscopia.

Palabras clave:
Urovysion
Carcinoma urotelial
Hibridación in situ fluorescente
Citología
Recurrencia
Seguimiento

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