How accurate is FISH for the diagnosis of bladder cancer?

Updated: Nov 01, 2018
  • Author: Gary David Steinberg, MD, FACS; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Answer

Initial comparisons of urine cytology with FISH for detecting bladder cancer recurrence showed that FISH yielded a greater sensitivity. [11] FISH is 42-83% sensitive for detecting pTa and pT1 lesions and 92-100% sensitive for pT2-4 invasive lesions in patients with known bladder cancer, while urine cytology yields sensitivities of 24-50% for pTa and pT1 lesions and 78-85% for pT2-4 invasive lesions. [12]

For suspected new cases of urothelial carcinoma, cytology yields a reported diagnostic sensitivity of 48%. [13]

Laudadio et al found that FISH is considerably more sensitive and only slightly less specific than cytology in diagnosing urothelial carcinoma. FISH analysis yielded a high sensitivity for detecting new cases of urothelial carcinoma, as well as recurrences. FISH detected 95% of cases with high-grade carcinoma, while cytology detected 41% of such cases. FISH yielded an overall specificity of 65%, compared to 93% with cytology. These researchers recommended FISH as a useful initial diagnostic tool in patients suspected of both new and recurrent bladder cancer.


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