Utilization of Multiprobe FISH in Papanicolaou-Stained Urine Cytology Helps Improve Detection of Chromosomal Alterations in Early Bladder Cancer or Tumor Recurrences
BA Walter Rodriguez, C Garcia-Macias, VA Valera Romero, MJ Merino. National Cancer Institute, National Institutes of Health, Bethesda; Universidad de Salamanca, Salamanca, Spain
Background: Urothelial carcinoma of the bladder is the most common form of urinary bladder cancer. Currently,urine cytology is the most common tool used as a complement to cytoscopy for detection of new bladder tumors and follow up for recurrences. Recent studies have shown that multiprobe FISH analysis in urine cytology is a valuable tool to detect chromosomal alterations that may be useful for bladder cancer diagnosis. In a new innovation of the technique, we combined the cytological features observed with the Papanicolau stain and the multiprobe FISH to detect chromosomally abnormal cells suggestive of cancer or tumor recurrences.
Design: Nineteen urine cytology archival specimens were studied with 15 corresponding biopsy samples available. Gross or microscopic hematuria was the most common clinical symptom. The cytology examples were evaluated and specific areas suspicious or clearly diagnosable of cancer were selected to perform the Multiprobe FISH (UroVysion®) assay. The number of signals for each probe for centromeric regions of chromosome 3, 7 and 17 as well for the specific locus 9p21 were registered and analyzed.
Results: Patient's median age was 76 y o. The diagnosis of Urothelial Carcinoma was confirmed in the 15 cases that had a corresponding biopsy: 55% were high grade lesions and 20% were low grade tumors. Four cytologies were reported as suspicious of malignancy. Chromosomal alterations were observed in most of the cells previously selected morphologically as malignant. Seventy-one percent of the high grade lesions showed polysomy of the chromosome 3 and chromosome 7, 57% for the chromosome 9 and 42% for the chromosome 17. Low grade lesions showed disomy for the centromeric probes and 33% complete loss of the 9p21. All the tissue biopsies showed similar chromosomal alterations.
Conclusions: Our study demonstrates that Multiprobe FISH performed in conjunction with Papanicolau staining is an excellent technique to detect chromosomal alterations in suspicious cytology. The technique also allows for the study of archival material. The selection of cytologically malignant cells as targets for FISH analysis may improve the detection of malignant cells in bladder cancer.
Category: Genitourinary (including renal tumors)
Wednesday, March 24, 2010 1:00 PM
Poster Session VI # 139, Wednesday Afternoon