Clinical decisions for treatment of different staged bladder cancer based on multitarget fluorescence in situ hybridization assays?

• Published in: World journal of urology Vol. 24; no. 4; pp. 418 - 422
• Main Authors: STEFFEN KRAUSE, F, RAUCH, Anita, SCHROTT, Karl M, ENGEHAUSEN, Dirk G
• Format: Journal Article
• Language: English
• Published: Heidelberg Springer 01-09-2006; Berlin; New York, NY
• Subjects: Biological and medical sciences; Chromosomes, Human, Pair 17; Chromosomes, Human, Pair 3; Chromosomes, Human, Pair 7; Chromosomes, Human, Pair 9; Humans; In Situ Hybridization, Fluorescence - methods; Investigative techniques, diagnostic techniques (general aspects); Medical sciences; Nephrology. Urinary tract diseases; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Sensitivity and Specificity; Tumors of the urinary system; Urinary Bladder Neoplasms - diagnosis; Urinary Bladder Neoplasms - genetics; Urinary system; Urinary tract. Prostate gland; Chromosomal aberration; Human; Nephrology; Urinary system disease; Multitarget FISH; Malignant tumor; Urinary tract disease; Bladder cancer; Urology; Cancerology; Diagnostical tool; Fluorescence in situ hybridization; Cytogenetics; Genetics; Abnormal chromosome; Bladder disease; Diagnosis; Molecular biology
• ISSN: 0724-4983; 1433-8726
• DOI: 10.1007/s00345-006-0086-y

Non-invasive methods for detecting genetic alterations of bladder cancer are increasingly becoming the focus of attention as diagnostic tools. The fluorescence in situ hybridization we performed to detect genetic alterations of chromosomes 3, 7, 9p21, and 17 (UroVysion Test) showed very high sensitivity, higher even than cytology, in detecting bladder tumors of varying differentiation (pTa-pT4). The use of this test in everyday clinical urology can be a very useful decision aid in treating problem cases. A pT1G3 bladder carcinoma in the presence of multichromosomal alterations should be treated as a muscle-invasive pT2 tumor. Other superficial bladder tumors (pTaGI-III, pT1GI-II) with negative histopathology in follow-up and positive FISH analysis with the UroVysion Test should have bladder mapping performed again. Although FISH analysis is currently the most sensitive marker for bladder tumors, the elaborate handling, the cost of the DNA probes and the laboratory equipment required, limit the use of this method in the urologist's everyday routine.