방광이행상피암의 진단 및 추적에서 배뇨소변을 이용한 Fluorescence in Situ Hybridization의 임상적 유용성
Clinical Utility of Fluorescence in Situ Hybridization for Voided Urine for the Diagnosis and Surveillance of Bladder Cancer
김지영, 김선희, 최한용, 이현무,
소속 상세정보
김지영 ( Kim Ji-Young )
성균관대학교 의과대학 삼성서울병원 비뇨기과학교실
김선희 ( Kim Sun-Hee )
성균관대학교 의과대학 삼성서울병원 진단검사의학교실
최한용 ( Choi Han-Yong )
성균관대학교 의과대학 비뇨기과학교실
이현무 ( Lee Hyun-Moo )
성균관대학교 의과대학 비뇨기과학교실
KMID : 0358320080490040307
Abstract
Purpose : To evaluate the clinical utility of performing fluorescence in situ hybridization(FISH) in voided urine specimens for the diagnosis and surveillance of bladder cancer, we compared the results of FISH with the results of urine cytology.
Materials & Methods : Voided urine samples from 196 patients were obtained for performing FISH and urine cytology. The bladder cancer group consisted of 76 patients who had biopsy-proven bladder cancer, and the control group was 120 patients without bladder cancer. FISH was performed using the UroVysion kit. The sensitivity and specificity of FISH were determined and compared with that of urine cytology.
Results : The overall sensitivity for FISH was significantly higher than the corresponding value for urine cytology(50% vs. 23.7%, respectively, p= 0.001). The specificities for FISH and cytology were 97.5% and 99.2%, respectively. When analyzing the results concerning the T-category, the sensitivity of FISH and cytology was 22.9% and 8.6% for pTa, 79.2% and 45.8% for pT1, and 54.5% and 9.1% for pT2-4 tumors, respectively. Concerning the tumor grade, the sensitivity was 22.2% and 5.6% for G1, 48.5% and 24.2% for G2, 70.8% and 33.3% for G3 for FISH and cytology, respectively.
Conclusion : These findings show that the sensitivity of FISH for voided urine samples is higher than that of cytology, but the specificity was not significantly different. We recommend FISH as a useful diagnostic tool for patients who are suspected of having new bladder cancer and recurrent cancer, in combination with performing urine cytology. (Korean J Urol 2008;49:307-312)
키워드
Bladder; Transitional cell carcinoma; In situ hybridization; Fluorescence; Cytology
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