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Comparative study of ProEx C immunocytochemistry and UroVysion fluorescent in-situ hybridization assays on urine cytology specimens.

Chang S, Smith E, Levin M, Rao JY, Moatamed NA - Cytojournal (2015)

Bottom Line: In this study, we compared the utility of ProEx C and UroVysion in urine specimens.Positive predictive value was 88.9% for ProEx C and 66.7% for UroVysion.Negative predictive value was 77.8% and 33.3% for ProEx C and UroVysion, respectively.

View Article: PubMed Central - HTML - PubMed

Affiliation: Address: Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.

ABSTRACT

Background: Detection of urothelial carcinoma (UC) by urine cytology can be challenging. Recently, ProEx C has been studied as a marker to improve detection of UC. ProEx C is an assay targeting expression of topoisomerase IIa and minichromosome maintenance protein-2 and is currently utilized to assist in diagnoses of the gynecological specimens. In this study, we compared the utility of ProEx C and UroVysion in urine specimens.

Materials and methods: Twenty-seven urine specimens with UroVysion assay analysis and surgical biopsy follow-up were selected. The smears were stained with ProEx C. ProEx C and UroVysion assay results were separated into two categories based on surgical biopsy follow-up (benign or neoplastic). Surgical biopsy diagnoses were used as the gold standard for comparative evaluation of the two assays. The surgical follow-up was 9 benign, 2 low grade, and 16 high grade UCs.

Results: The sensitivity was 88.9% for ProEx C and 55.6% for UroVysion, while the specificity was 77.8% for ProEx C and 44.4% for UroVysion. Positive predictive value was 88.9% for ProEx C and 66.7% for UroVysion. Negative predictive value was 77.8% and 33.3% for ProEx C and UroVysion, respectively. Using the two-tailed paired t-test, P value of 0.033 was obtained when ProEx C stain was compared with the UroVysion assay.

Conclusion: ProEx C immunocytochemistry has a more favorable performance than fluorescent in-situ hybridization with a significant difference between the two assays using paired two-tail t-test (P = 0.0033).

No MeSH data available.


Related in: MedlinePlus

An example of UroVysion fluorescent labeling in an abnormal cell. These studies showed an abnormal signal pattern (aneusomy of chromosomes 3, 7, or 17, or deletion of the 9p21 locus) in 17 of the cells analyzed magnification. The follow-up surgical biopsy showed high grade urothelial carcinoma [case #27, Table 1]
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Figure 2: An example of UroVysion fluorescent labeling in an abnormal cell. These studies showed an abnormal signal pattern (aneusomy of chromosomes 3, 7, or 17, or deletion of the 9p21 locus) in 17 of the cells analyzed magnification. The follow-up surgical biopsy showed high grade urothelial carcinoma [case #27, Table 1]

Mentions: UroVysion™ Bladder Cancer Kits were obtained from Abbott Laboratories (1300 E. Touhy Ave., Des Plaines, IL, USA). Each kit contained three alpha-satellite repeat sequences or chromosome enumeration probes (CEP) for chromosome-3 (SpectrumRed), chromosome-7 (SpectrumGreen), and chromosome-17 (SpectrumAqua). In the assay, the three CEP hybridize to the centromeric regions of chromosomes 3, 7, and 17, respectively. In addition, a unique sequence locus specific identifier probe (SpectrumGold) was included to detect P16 gene on p21 locus of chromosome 9. The urinary specimens were processed for the FISH assay according to the Food and Drug Administration (FDA) approved methodology as described in the product insert. An epifluorescence microscope equipped with appropriate excitation and barrier filters was used to visualize and record the signals. In this process, nuclear DAPI and the respective probe signal images were individually photographed for accurate signal counting then the acquired images were combined to form a complete image of the cells. According to the FDA criteria, the normal diploid urothelial cells have two signals for each chromosome [Figure 1]. An abnormal FISH assay for a suspected urothelial neoplasia would require a minimum of four cells with polysomy of at least two of the four chromosomes [Figure 2] or a minimum of 12 cells with homozygous loss of P16 genes when a minimum of 25 large atypical cells were examined. Umbrella cells were excluded for evaluation.[15]


Comparative study of ProEx C immunocytochemistry and UroVysion fluorescent in-situ hybridization assays on urine cytology specimens.

Chang S, Smith E, Levin M, Rao JY, Moatamed NA - Cytojournal (2015)

An example of UroVysion fluorescent labeling in an abnormal cell. These studies showed an abnormal signal pattern (aneusomy of chromosomes 3, 7, or 17, or deletion of the 9p21 locus) in 17 of the cells analyzed magnification. The follow-up surgical biopsy showed high grade urothelial carcinoma [case #27, Table 1]
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4325383&req=5

Figure 2: An example of UroVysion fluorescent labeling in an abnormal cell. These studies showed an abnormal signal pattern (aneusomy of chromosomes 3, 7, or 17, or deletion of the 9p21 locus) in 17 of the cells analyzed magnification. The follow-up surgical biopsy showed high grade urothelial carcinoma [case #27, Table 1]
Mentions: UroVysion™ Bladder Cancer Kits were obtained from Abbott Laboratories (1300 E. Touhy Ave., Des Plaines, IL, USA). Each kit contained three alpha-satellite repeat sequences or chromosome enumeration probes (CEP) for chromosome-3 (SpectrumRed), chromosome-7 (SpectrumGreen), and chromosome-17 (SpectrumAqua). In the assay, the three CEP hybridize to the centromeric regions of chromosomes 3, 7, and 17, respectively. In addition, a unique sequence locus specific identifier probe (SpectrumGold) was included to detect P16 gene on p21 locus of chromosome 9. The urinary specimens were processed for the FISH assay according to the Food and Drug Administration (FDA) approved methodology as described in the product insert. An epifluorescence microscope equipped with appropriate excitation and barrier filters was used to visualize and record the signals. In this process, nuclear DAPI and the respective probe signal images were individually photographed for accurate signal counting then the acquired images were combined to form a complete image of the cells. According to the FDA criteria, the normal diploid urothelial cells have two signals for each chromosome [Figure 1]. An abnormal FISH assay for a suspected urothelial neoplasia would require a minimum of four cells with polysomy of at least two of the four chromosomes [Figure 2] or a minimum of 12 cells with homozygous loss of P16 genes when a minimum of 25 large atypical cells were examined. Umbrella cells were excluded for evaluation.[15]

Bottom Line: In this study, we compared the utility of ProEx C and UroVysion in urine specimens.Positive predictive value was 88.9% for ProEx C and 66.7% for UroVysion.Negative predictive value was 77.8% and 33.3% for ProEx C and UroVysion, respectively.

View Article: PubMed Central - HTML - PubMed

Affiliation: Address: Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.

ABSTRACT

Background: Detection of urothelial carcinoma (UC) by urine cytology can be challenging. Recently, ProEx C has been studied as a marker to improve detection of UC. ProEx C is an assay targeting expression of topoisomerase IIa and minichromosome maintenance protein-2 and is currently utilized to assist in diagnoses of the gynecological specimens. In this study, we compared the utility of ProEx C and UroVysion in urine specimens.

Materials and methods: Twenty-seven urine specimens with UroVysion assay analysis and surgical biopsy follow-up were selected. The smears were stained with ProEx C. ProEx C and UroVysion assay results were separated into two categories based on surgical biopsy follow-up (benign or neoplastic). Surgical biopsy diagnoses were used as the gold standard for comparative evaluation of the two assays. The surgical follow-up was 9 benign, 2 low grade, and 16 high grade UCs.

Results: The sensitivity was 88.9% for ProEx C and 55.6% for UroVysion, while the specificity was 77.8% for ProEx C and 44.4% for UroVysion. Positive predictive value was 88.9% for ProEx C and 66.7% for UroVysion. Negative predictive value was 77.8% and 33.3% for ProEx C and UroVysion, respectively. Using the two-tailed paired t-test, P value of 0.033 was obtained when ProEx C stain was compared with the UroVysion assay.

Conclusion: ProEx C immunocytochemistry has a more favorable performance than fluorescent in-situ hybridization with a significant difference between the two assays using paired two-tail t-test (P = 0.0033).

No MeSH data available.


Related in: MedlinePlus