The value of the UroVysion(R) FISH assay in the risk-stratification of patients with quot;atypical urothelial cellsquot; in urinary cytology specimens Journal Article


Authors: Virk, R. K.; Abro, S.; de Ubago, J. M. M.; Pambuccian, S. E.; Quek, M. L.; Wojcik, E. M.; Mehrotra, S; Chatt, G. U.; Barkan, G. A.
Article Title: The value of the UroVysion(R) FISH assay in the risk-stratification of patients with quot;atypical urothelial cellsquot; in urinary cytology specimens
Abstract: BACKGROUND: The aim of this study was to evaluate the potential use of the UroVysion(R) fluorescent in situ hybridization test (U-FISH) to stratify the risk of urothelial carcinoma (UC) in patients with a diagnosis of quot;atypical urothelial cellsquot; (AUC) in urinary tract cytology (UTCy). METHODS: Using a histologic diagnosis of UC and respectively of high grade UC (HGUC) within 12 months of the index UTCy as a reference standard, we determined the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of U-FISH for patients with AUC diagnosed 2008 to 2014. RESULTS: Of the 377 patients with AUC, 62 (16.45%) were diagnosed with UC (29 low grade UC and 33 HGUC) within 12 months. U-FISH were uninformative in 45 (11.94%), positive in 63 (16.71%) and negative in 269 (71.35%). UC was diagnosed more frequently in patients with positive than in those with negative U- FISH results (31/63, 49.21% vs. 25/269, 9.29%, P lt; 0.0001). The sensitivity, specificity, PPV, NPV and accuracy of U-FISH in the setting of AUC were 44.64%, 81.82%, 47.17%, 80.25%, and 71.91% for UC and respectively 48.39%, 78.77%. 28.3%, 89.81%, and 74.29% for HGUC. U-FISH showed a high false positive rate (28/53, 52.83%) that remained high even after extended follow-up, arguing against quot;anticipatory positivequot; results. CONCLUSIONS: U-FISH allows risk stratification in patients with AUC. However, its usefulness is diminished by the high false-positive rate, making it important to interpret U- FISH results in the patient#39;s clinical context. Diagn. Cytopathol. 2017;45:481-500. (c) 2017 Wiley Periodicals, Inc.
Keywords: Pathology; urothelial carcinoma; urine cytology; FISH; STARD; UroVysion(R); sensitivity; specificity
Journal Title: Diagnostic cytopathology
Volume: 45
Issue: 6
ISSN: 1097-0339; 1097-0339
Publisher: Wiley Periodicals, Inc  
Journal Place: United States
Date Published: 2017
Start Page: 481
End Page: 500
Language: eng
DOI/URL:
Notes: LR: 20170509; CI: (c) 2017; JID: 8506895; OTO: NOTNLM; 2016/03/07 [received]; 2016/12/12 [revised]; 2016/12/15 [accepted]; ppublish