ABSTRACT
Patients with bladder cancer are still requiring close follow up with frequent cystoscopies. This study aims to assess the FISH analysis, as a procedure capable of highlighting the hidden features of a tumor and helping to individualize treatment tactics. The bladder washings of 50 primary bladder cancer patients were taken prior to TURB and analyzed with the commercial FISH assay UroVysion®. All patients were divided into groups according to the maximum stage and grade of the tumor. The sensitivity of the method was 81.5 %, 91.7 % and 100 % for the Ta, T1 and T2 stage groups, respectively. For the G1, G2 and G3 groups the sensitivity was 70 %, 100 % and 100 %, respectively. In addition, the rate of detecting genetically abnormal cells was significantly higher in the T2 stage compared to the Ta and combined Ta+T1 groups, as well as in the G3 group compared to the G1 and G2 groups. The mean signal number from each chromosome insignificantly increased with the stage and grade of the tumor. The detection of <40 % genetically abnormal cells predicted the absence of muscle invasion and a G3 tumor with more then 90 % reliability. The FISH method is highly sensitive in early bladder cancer detection and is able to predict the morphological character of a tumor even before surgery.
Subject(s)
Chromosomes, Human , Urinary Bladder Neoplasms/genetics , Chromosome Aberrations , Fluorescent Dyes/chemistry , Humans , In Situ Hybridization, Fluorescence/methods , Neoplasm Grading , Neoplasm Staging , Prospective Studies , Reproducibility of Results , Sensitivity and Specificity , Urinary Bladder Neoplasms/pathologyABSTRACT
Our study was concerned with assessing the results of FISH analysis as a procedure to detect occult features of tumor and contribute to individualizing treatment strategies. It included a cohort of 50 patients with primary bladder tumors who had undergone transurethral resection. Washings from all patients were tested using UroVysion protocol immediately prior to surgery. Patients were divided into groups according to stage and grade of tumor. The sensitivities were 81.5%, 91.7% and 100% for Ta, T1 and T2 groups, respectively. In G1, G2 and G3 groups, the sensitivities were 70%, 100% and 100%, respectively. Besides, the rate of detecting genetically abnormal cells was significantly higher at stage T2 as compared with Ta and Ta+T1 groups. It was also higher in G3 group as compared with G1 for Ta and G2. No significant differences in the mean number of signals from each chromosome was reported. Frequency rates of abnormal cells of less than 40% correlated with absence of invasion into the muscular layer and poorly-differentiated cell status. They rose insignificantly in proportion to stage and grade. Detection of less than 40% of genetically abnormal cells correlated with absence of mascular invasion and G3 tumor (90% credibility). FISH diagnostic procedure showed high sensitivity of detecting even at incipient stage of bladder carcinoma and was instrumental in preoperative predicting type of tumor.
