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Nove možnosti citopatološke diagnostike raka sečnega mehurja s testom UroVysion
Strojan Fležar, Margareta
1.04 - Professional Article
OI - Institute of Oncology
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New Promises of Cytopathologic Diagnostics of Bladder cancer by Using UroVysion™
Cytopathologic examination of the urine and bladder washing is a standard method for the detection of primary bladder cancer in symptomatic patients or in patients with hematuria. The method is also very useful to follow the patients after treatment in order to detect recurrence of bladder cancer which occurs in a significant percentage of patients. Cytopathologic examination is highly accurate for the diagnosis of high grade urothelial carcinoma and carcinoma in situ. However, the method is recognized as being unreliable for the detection of low grade urothelial neoplasms. Obvious cellular and nuclear morphological signs of malignancy can be reliably recognized in high grade papillary, invasive and in situ urothelial carcinoma. Thus, less pronounced cellular atypia pose everyday diagnostic problems and atypia of low grade papillary neoplasms cannot be always reliably differentiated from atypia of some benign and post-treatment reactive changes. In the last decade a number of new urinary markers have been developed to overcome low sensitivity of urinary cytology. Although most of these tests are highly sensitive, they have lower specificity than cytology. The UroVysion test seems the most promising among the new tests. By the method of multitarget fluorescent in situ hybridisation (FISH), the test can detect several cytogenetic changes characteristic for different grades of bladder cancer. Therefore, the UroVysion test is useful for assessing neoplastic nature of cytologically undetermined atypical cells. The most recent reports claim that the UroVysion test can even detect bladder cancer before morphological changes are diagnosed in urine cytology.