DNA-based molecular cytology for bladder cancer surveillance

J. Stephen Jones, H. Barton Grossman, Mark S. Soloway, Colin P N Dinney, Victor E. Reuter, Louis S. Liou, Michael L. Blute

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

Surveillance strategies for urothelial cancer (UC) recurrence have historically relied on the diagnostic combination of cystoscopy and conventional urinary cytology. In this review, results of studies evaluating the role of the fluorescence in situ hybridization (FISH) assay in bladder cancer surveillance are critically examined. The published research on FISH compared with conventional cytology and cystoscopy for bladder cancer was identified using a Medline search and was critically analyzed. Sensitivity and specificity data were tabulated and compared. FISH outperformed conventional cytology across all stages and grades in all published reports, and it detected malignancy before the development of lesions visible by cystoscopy. Although overall sensitivity was 48% for cytology and 74% for FISH, its greatest advantage was in the detection of high-grade UC, including carcinoma in situ (CIS). Cumulative data from comparative studies showed the sensitivity of cytology compared with FISH was 19% versus 58% for grade 1, 50% versus 77% for grade 2, and 71% versus 96% for grade 3. Similar findings occurred by stage, where cytology compared with FISH sensitivity was 35% versus 64% for Ta, 66% versus 83% for T1, and 76% versus 94% for muscle-invasive carcinoma. Notably, cytology detected only 67% of CIS versus 100% detection by FISH. Specificity data were comparable. Unlike conventional urinary cytology and cystoscopy, which depend on subjective visible microscopic or macroscopic changes, FISH allows identification of chromosomal abnormalities associated with malignant development before phenotypic expression of those alterations. Use of morphologic cellular changes allows more rapid detection of such alterations, combining the benefits of conventional cytology with molecular diagnostics. It is apparent that we are in the early phases of realizing the potential of molecular diagnostics.

Original languageEnglish
Pages (from-to)35-47
Number of pages13
JournalUrology
Volume67
Issue number3 SUPPL. 1
DOIs
StatePublished - Mar 1 2006
Externally publishedYes

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Urinary Bladder Neoplasms
Fluorescence In Situ Hybridization
Cell Biology
DNA
Cystoscopy
Molecular Pathology
Carcinoma in Situ
Neoplasms
Chromosome Aberrations
Carcinoma
Recurrence
Sensitivity and Specificity
Muscles
Research

ASJC Scopus subject areas

  • Urology

Cite this

Jones, J. S., Grossman, H. B., Soloway, M. S., Dinney, C. P. N., Reuter, V. E., Liou, L. S., & Blute, M. L. (2006). DNA-based molecular cytology for bladder cancer surveillance. Urology, 67(3 SUPPL. 1), 35-47. https://doi.org/10.1016/j.urology.2006.01.039

DNA-based molecular cytology for bladder cancer surveillance. / Jones, J. Stephen; Grossman, H. Barton; Soloway, Mark S.; Dinney, Colin P N; Reuter, Victor E.; Liou, Louis S.; Blute, Michael L.

In: Urology, Vol. 67, No. 3 SUPPL. 1, 01.03.2006, p. 35-47.

Research output: Contribution to journalArticle

Jones, JS, Grossman, HB, Soloway, MS, Dinney, CPN, Reuter, VE, Liou, LS & Blute, ML 2006, 'DNA-based molecular cytology for bladder cancer surveillance', Urology, vol. 67, no. 3 SUPPL. 1, pp. 35-47. https://doi.org/10.1016/j.urology.2006.01.039
Jones JS, Grossman HB, Soloway MS, Dinney CPN, Reuter VE, Liou LS et al. DNA-based molecular cytology for bladder cancer surveillance. Urology. 2006 Mar 1;67(3 SUPPL. 1):35-47. https://doi.org/10.1016/j.urology.2006.01.039
Jones, J. Stephen ; Grossman, H. Barton ; Soloway, Mark S. ; Dinney, Colin P N ; Reuter, Victor E. ; Liou, Louis S. ; Blute, Michael L. / DNA-based molecular cytology for bladder cancer surveillance. In: Urology. 2006 ; Vol. 67, No. 3 SUPPL. 1. pp. 35-47.
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