The Role of Suspicious UroVysion Cases as a Monitor for Bladder Cancer
S Nishtar, A Khan, PJ Ringer, L Toomer, MN Qureshi. QDx Pathology Services, Cranford, NJ
Background: UroVysion, (Abbott Molecular, Des Plaines, IL), is a fluorescence in situ hybridization (FISH) assay which detects chromosomal abnormalities commonly associated with bladder cancer including aneuploidy of chromosomes 3, 7, 17 and loss of both copies of 9p21 loci. A positive FISH result is defined as a gain of two or more of chromosomes 3, 7 or 17 in four (4) or more cells or isolated loss of both copies of 9p21 in twelve (12) or more cells. These chromosomal abnormalities have a high predictive index for the presence or development of bladder cancer in patients with a known history of bladder cancer and hematuria of unknown cause. In our institute, we recognize aneuploidy in 2-3 cells (less than four cells) as a “suspicious category”, which does not fit the standard criteria for a positive FISH test.
Design: We monitored the follow-up outcome of 30 patients that were suspicious for FISH. 15 patients out of 30 (50%) had an initial diagnosis of hematuria, 15 out of 30 (50%) had a diagnosis of bladder cancer. 6 out of 15 (40%) patients with a history of bladder cancer had a follow up biopsy done within a period of four to eight weeks.
Results: 3 out of 6 (50%) patients had a positive bladder biopsy for cancer whereas 3 out of 6 (50%) patients had a negative outcome. Of the remaining nine (9) patients with bladder cancer and fifteen (15) with a history of hematuria, concurrent or short-term (4-8 weeks) follow-up with urine cytologies showed atypia in 20 out of 24 (83.3%) cases. All others had negative urine cytology results.
Conclusions: Based on our preliminary data, suspicious FISH cases warrant further follow-up and careful monitoring for the primary detection or recurrence of bladder cancer. Longer term follow- up will be provided.
Category: Genitourinary (including renal tumors)
Wednesday, March 24, 2010 1:00 PM
Poster Session VI # 138, Wednesday Afternoon