Diagnostic performance of fluorescence in situ hybridization (FISH) in upper tract urothelial carcinoma (UTUC): a systematic review and meta-analysis

Abstract

Background Fluorescence in situ hybridization (FISH) is a technique that uses fluorescently labeled DNA probes. Many studies have evaluated the ROC curve (sensitivity and specificity) with the FISH method to diagnose upper tract urothelial carcinoma (UTUC). The current meta-analysis was performed to examine the diagnostic power of the FISH method in UTUC. Methods We reviewed databases and methodically obtained papers for analysis until April 25th, 2022. The Meta-disc V.1.4 and Comprehensive Meta-Analysis V.3.3 software calculated the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, area under the curve (AUC), and summary receiver-operating characteristic (SROC). The I² and Chi-square tests were used to examine the heterogeneity. Finally, the publication bias was estimated using Begg’s and Egger’s tests. Results A total of 13 articles included 1,067 participants (439 cases and 628 controls). The overall pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the curve (AUC) were 0.72 (95% CI 0.67–0.76), 0.95 (95% CI 0.93–0.97), 10.42 (95% CI 5.84–18.60), 0.29 (95% CI 0.21–0.40), 38.55 (95% CI 18.58–79.96), and 0.91, respectively. No publication bias was reported based on Begg’s and Egger’s tests (Begg’s p = 0.200; Egger’s p = 0.151). Conclusion This paper clearly shows that the high specificity and acceptable sensitivity of the FISH method make it a promising diagnostic method for UTUC in urine samples. However, further research with higher statistical numbers is needed to strengthen the correlation and be used for diagnostic applications.