Zusammenfassung
Der Nachweis chromosomaler Veränderungen mittels Fluoreszenz-in-situ-Hybridisierung (FISH) kann die diagnostische Aussagekraft in der Zytologie markant verbessern. Nahezu jedes zytologische Präparat kann unabhängig von Entnahmeart, Fixation und Färbung mittels FISH untersucht werden. FISH verbessert die Sensitivität der Urothel- und Lungenkarzinomdiagnostik und eignet sich besonders zur Abklärung unklarer Atypien. Sie erlaubt eine zuverlässige Unterscheidung maligner von reaktiv veränderten Mesothelien. Spezifische Translokationen für die Diagnose gewisser Lymphome und Sarkome sind mittels FISH einfach nachweisbar. Die Untersuchung auf eine HER2-Amplifikation ist bei Mammakarzinomen zum Standard geworden. Die simultane FISH-Untersuchung von humanen Papillomaviren (HPV) und ausgewählter Gene könnte sich in der gynäkologischen Vorsorgezytologie als nützlich erweisen. Das Spektrum klinisch relevanter Anwendungen dieser Methode wird sich auch in Zukunft kontinuierlich erweitern.
Abstract
Fluorescence in situ hybridization (FISH) is a powerful method for the identification of chromosomal aberrations to improve the diagnostic performance of cytology. FISH is applicable to almost any type of cytological specimen irrespective of cell type, staining or fixation modality. Multi-target tests for the simultaneous analysis of four chromosomes or chromosomal loci improves the sensitivity of cytological diagnosis in bladder and lung cancer and is most helpful in equivocal cytology. FISH also allows a reliable distinction between malignant mesothelioma and reactive mesothelial cells. Specific translocations can easily be detected by FISH for precise diagnosis of lymphomas and sarcomas. Testing for HER-2 amplification has become a standard method to select patients with breast cancer for therapy with trastuzumab. Co-analysis of HPV and selected genes could become a useful approach in gynecological cytology. The spectrum of diagnostic FISH applications is continuously growing.
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Interessenkonflikt
Der korrespondierende Autor weist auf folgende Beziehungen hin: L. Bubendorf erhielt finanzielle Forschungsunterstützung durch die Firma Abbott/Vysis und ist als Referent für diese Firma tätig.
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Savic, S., Bubendorf, L. Fluoreszenz-in-situ-Hybridisierung. Pathologe 28, 384–392 (2007). https://doi.org/10.1007/s00292-007-0930-x
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DOI: https://doi.org/10.1007/s00292-007-0930-x