The combined application of urinary liquid-based cytology with fluorescence in situ hybridization and p16/Ki-67 dual immunostaining is valuable for improving the early diagnosis of upper tract urothelial carcinomas

Diagn Cytopathol. 2017 Oct;45(10):895-902. doi: 10.1002/dc.23796. Epub 2017 Aug 11.

Abstract

Objectives: To evaluate the diagnostic values of urine liquid-based cytology (LBC), fluorescence in situ hybridization (FISH), and p16/Ki-67 dual immunostaining in the detection of upper tract urothelial carcinomas (UTUCs).

Methods: Sixty-one patients with UTUCs were retrospectively analyzed. All patients were diagnosed both by urine cytology and by FISH, and histologically confirmed as UTUCs. Thirty-two patients had been stained with p16/Ki-67 dual labeling.

Results: The sensitivities for low-grade UTUCs (LGUTUCs) and high-grade UTUCs (HGUTUCs) were 33.3% and 67.4% by LBC, 60% and 69.6% by FISH, and 12.5% and 66.7% by p16/Ki-67 dual labeling, respectively.

Conclusions: Our results indicated that LBC was more suitable to identify HGUTUCs, FISH was highly valuable for predicting LGUTUCs, and p16/Ki-67 dual labeling was useful for distinguishing HGUTUCs from LGUTUCs. The combined application of these methods may improve the sensitivity or accuracy in the detection or diagnosis of UTUCs.

Keywords: diagnosis; fluorescence in situ hybridization (FISH); liquid-based cytology (LBC); p16/Ki-67 dual labeling; upper tract urothelial carcinomas (UTUCs).

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma / pathology*
  • Case-Control Studies
  • Cyclin-Dependent Kinase Inhibitor p16 / metabolism*
  • Early Detection of Cancer / methods*
  • Early Detection of Cancer / standards
  • Female
  • Humans
  • Immunoassay / methods
  • Immunoassay / standards
  • In Situ Hybridization, Fluorescence / methods
  • In Situ Hybridization, Fluorescence / standards
  • Ki-67 Antigen / metabolism*
  • Male
  • Middle Aged
  • Molecular Diagnostic Techniques / methods*
  • Molecular Diagnostic Techniques / standards
  • Urinary Bladder Neoplasms / pathology*
  • Urothelium / pathology*

Substances

  • CDKN2A protein, human
  • Cyclin-Dependent Kinase Inhibitor p16
  • Ki-67 Antigen