The Research On The Application Of Fluorescence In Situ Hybridization In Diagnosis Of Urinary Bladder Cancer

Objective:To compare the sensitivities and specificities of fluorescence in situ hybridization(FISH)and cytology for the detection of urinary bladder cancer.Methods:A mixture of fluorescent labeled probes to the centromeres of chromosomes 3,7 and 17,and band 9p21 was used to detect urinary cells for chromosomal abnormalities.From October 2007 to April 2008,265 hematuria patients,including 150 with a history of urinary bladder cancer and 115 without a history of urinary bladder cancer,were treated in minimally invasive urology center of Shandong Provincial Hospital.A total of 280 urine specimens from these 265 patients were analyzed in this research.FISH analysis was performed without prior knowledge of clinical findings,that is biopsy,cystoscopy and cytology results.A positive result was defined as 5 or more urinary cells with gains of 2 or more abnormal chromosomes.Results:A total of 75 biopsies showed urinary bladder cancer the 265 patients.The sensitivity of urine cytology for Ta(36 cases),Tis(18) and T1-T4(15)tumors was 47%,78%and 60%,respectively,for an overall sensitivity of 58%.The sensitivity of FISH for T3(37 cases),Tis(17) and T1-T4(19)tumors was 65%,100%and 95%,respectively,for an overall sensitivity of 81%.FISH was significantly more sensitive than cytology for Tis(p=0.046),T1-T4(p=0.025),grade 3(p=0.003)and all tumors (p=0.001).The specificity of cytology and FISH among patients without cystoscopic evidence of urinary bladder cancer and no history of urinary bladder cancer was 98%and 96%,respectively(p=0.564).Conclusions:The sensitivity of FISH for the detection of urinary bladder cancer is superior to that of cytology,and the specificity of FISH and cytology for urinary bladder cancer are not significantly different.FISH can improve significantly the diagnosis of urinary bladder cancer and will be significant for screening of urinary bladder cancer.