Detection Of Chromosomes And NMP22 In Urine Exfoliated Cells As Adjunct Methods For Urine Cytologic Diagnosis Of Bladder Cancer

Objectives:To investigate the value of Urine LBC, FISH and NMP22 BladderChek in diagnosis of bladder cancer, and to evaluate the significance of abnormality of chromosome 3,7,9,17 and deletion of 9p21 in bladder cancer.Materials and methods:Voided urine samples were collected from inpatients and outpatients in the Department of Urology, Cancer Hospital of Chinese Academy of Medical Science (CHCAMS). In addition, voided urine samples were also collected from the healthy individuals for medical examination at out-patients department. Urine LBC, FISH and NMP22 BladderChek were performed. CEP3, CEP7, CEP9, CEP17 and LSI 9P21 were selected for FISH.Results:175 cases included 104 UC,16 benign lesions,8 cases with history of urinary tumor and without recurrence,10 non-urothelial malignancy and 37 healthy controls.1. Sensitivities of Urine LBC, FISH, NMP22 BladderChek were 73.1%,86.5% and67.6%, respectively. Specificities of Urine LBC, FISH, NMP22 BladderChek were 90.2%,92.6%and88.1%, respectively. FISH was more sensitive than LBC (P=0.022) and NMP22 BladderChek (P=0.004); Statistical difference was not found among the specificities of all 3 methods.2. The positive rates of FISH in AUC and SuCA diagnosed by LBC in UC and non-UC were 85.7%(24/28) and 37.5%(3/8), the difference reached statistical significance (P=0.021), while the positive rates of NMP22 BladderChe were 61.9% (13/21) and 50.0%(4/8), difference failed to reach statistical significance (P=0.683).3. For bladder UC G1/G1-2,G2/G2-3 and G3, the sensitivities of Urine LBC were 43.6%,85.0%and 95.0%, the sensitivities of NMP22 BladderChek were 51.7%,66.7%and 91.7%, and for FISH were 69.0%.88.9%and 94.4%. FISH was more sensitive than cytology in bladder UC G1/G1-2 (P=0.038). The sensitivities of all 3 methods increased with the UC grades increasing (LBC:P＜0.001, FISH:P=0.022, NMP22 BladderChek:P=0.009).4. Five strong and 10 weak positive results of NMP22 BladderChek were found in bladder UC G1/G1-2,8 strong and 2 weak in G2/G2-3,9 strong and 2 weak in G3. Strong positive results were more popular in high grade UC, while weak positive ones more popular in low grade UC (P=0.009).6. The positive rates of CEP7 and CEP 17 rised with the UC grade increasing (CEP7:P=0.014; CEP17:P=0.002). Both deletion and polyploid can be found at 9p21. The rate of polyploid at 9p21 was 25.0%。Conclusions:In the diagnosis of UC, FISH was more sensitive than Urine LBC and NMP22 Bladderchek. The sensitivities of all the 3 methods increased with the UC grades increasing. FISH was helpful in identification of SuCA and AUC diagnosed by cytology. Strong and weak positive results of NMP22 BladderChek were more popular in high grade UC and low grade UC, respectively.