Title

Two-tiered subdivision of atypia on urine cytology can improve patient follow-up and optimize the utility of UroVysion

Publication Date

2016

Journal Title

Cancer Cytopathol

Abstract

BACKGROUND: The annual incidence of urothelial carcinoma continues to increase, and it is projected that greater than 70,000 new cases will occur in the year 2015. However, as much as 23% of cytologic specimens will demonstrate some degree of atypia without meeting the criteria for urothelial carcinoma and thus will be reported as atypical. METHODS: The authors conducted 2 laboratory information searches and 1 survey. In total, 311 patients who had atypical cytology-biopsy pairs available were identified from the initial data search. The second data search identified 942 patients who had fluorescence in situ hybridization (FISH) results available. RESULTS: There was fair agreement between FISH results and cytology results (kappa = 0.34; 95% confidence interval, 0.27-0.41). The analysis did not reveal any benefits of using additional atypical subcategories beyond the 2 suggested in the literature. It was determined that 2 strategies would provide an optimal balance: standardizing patient management and facilitating the adoption of universally recognized templates. CONCLUSIONS: When combining cytology and the 2-tiered atypical classification system with FISH testing, a marked increase in sensitivity and an accompanying decrease in specificity were observed compared with either test individually. Thus, highly sensitive FISH testing may help to identify high-risk patients among those in the group with uncertain atypical findings. Cancer (Cancer Cytopathol) 2015. (c) 2015 American Cancer Society.

Volume Number

124

Issue Number

3

Pages

188-95

Document Type

Article

EPub Date

2015/10/03

Status

Faculty; Northwell Researcher; Northwell Resident

Facility

School of Medicine; Northwell Health

Primary Department

Pathology and Laboratory Medicine

PMID

26430812

DOI

10.1002/cncy.21630