Moonen Paula M J, Merkx Gerard F M, Peelen Pim, Karthaus Herbert F M, Smeets Dominique F C M, Witjes J Alfred
Department of Urology, Radboud University Nijmegen Medical Centre, 6500 HB Nijmegen, The Netherlands.
Eur Urol. 2007 May;51(5):1275-80; discussion 1280. doi: 10.1016/j.eururo.2006.10.044. Epub 2006 Oct 30.
The multitarget fluorescence in situ hybridization probe set Vysis UroVysion, consisting of probes for chromosomes 3, 7, and 17 and for the 9p21 band, was studied to evaluate its value in the follow-up of patients with bladder cancer. The results were compared with conventional cytology and quantitative cytology (Quanticyt). The aim of this study was to evaluate whether UroVysion is a better adjunct to urethrocystoscopy than cytology and quantitative cytology.
UroVysion, cytology, and quantitative cytology were performed on 113 voided urinary samples of 105 patients under surveillance for non-muscle-invasive bladder cancer. Before urethrocystoscopy or transurethral resection of the bladder, a voided urinary sample was obtained. Results of all tests were compared to evaluate the value of UroVysion.
Sixty-four patients had biopsy-proven urothelial cell carcinoma. Sensitivity and specificity were, respectively, 39.1% and 89.7% for UroVysion, 40.6% and 89.7% for cytology, and 42.1% and 67.9% for quantitative cytology. When the UroVysion test and cytology were combined, sensitivity increased to 53.1%, but specificity decreased to 79.5%. Detection of Ta tumours was equal for cytology and UroVysion (26.7%), detection of T1 and T2-T4 samples by UroVysion was 60% and 50%, respectively. Detection of grade 1, 2, and 3 tumours by UroVysion was 21.4%, 36.8%, and 66.7%, respectively. In four cases the UroVysion test was positive, but no abnormalities were seen at cystoscopy.
Our data suggest that the use of UroVysion provides no improvement over cytology or quantitative cytology in the diagnosis of recurrent non-muscle-invasive bladder tumours.
研究多靶点荧光原位杂交探针组Vysis UroVysion(由针对3号、7号和17号染色体以及9p21带的探针组成)在膀胱癌患者随访中的价值。将结果与传统细胞学和定量细胞学(Quanticyt)进行比较。本研究的目的是评估UroVysion相对于细胞学和定量细胞学而言,是否是尿道膀胱镜检查更好的辅助手段。
对105例非肌层浸润性膀胱癌监测患者的113份排尿样本进行UroVysion、细胞学和定量细胞学检查。在尿道膀胱镜检查或经尿道膀胱肿瘤电切术前,获取一份排尿样本。比较所有检查结果以评估UroVysion的价值。
64例患者经活检证实为尿路上皮癌。UroVysion的敏感性和特异性分别为39.1%和89.7%,细胞学分别为40.6%和89.7%,定量细胞学分别为42.1%和67.9%。当UroVysion检测与细胞学联合使用时,敏感性提高到53.1%,但特异性降至79.5%。细胞学和UroVysion对Ta肿瘤的检测率相同(26.7%),UroVysion对T1和T2 - T4样本的检测率分别为60%和50%。UroVysion对1级、2级和3级肿瘤的检测率分别为21.4%、36.8%和66.7%。有4例UroVysion检测呈阳性,但膀胱镜检查未见异常。
我们的数据表明,在复发性非肌层浸润性膀胱肿瘤的诊断中,使用UroVysion相对于细胞学或定量细胞学并无优势。