Clinical Evaluation Of A Fluorescence In Situ Hybridization Assay For Detection Of Urothelial Tumor

Objective:To establish the experimental platform of sample treatment,quality control Fluorescence in situ hybridization(FISH);Detect the chromosome abnormalities in the urine exfoliated cells of patients with urothelial carcinoma.To discuss the value of FISH as a not invasive diagnosis method for urothelial carcinoma and the value of the detection of prognosis of bladder cancer.Methods:Urine samples of both suspected urothelial carcinoma patients and healthy controls were collected,urine cytology and FISH were synchronously checked.FISH were used to detect the abnormalities of chromosome 3,7,17 and p16.115 suspected patients of urothelial carcinoma and 20 healthy controls were enrolled in this experiment.Data of the healthy group were collected to establish the threshold and patients of carcinoma were diagnosed by this threshold.Through the comparison and statistical analysis between the results of the experiments and pathology,we concluded the sensitivity and specificity of the two methods,as well the difference between high grade and low grade carcinomas.Results:Urine samples of patients with urothelial carcinoma have obviously increased chromosome abnomilities compared with the control group.After the threshold were established,the results of FISH and urine cytology were compared.The sensitivity and specificity of urine cytology were 10%and 100%respectively,the sensitivity and specificity of FISH were 86.7%and 96%respectively,the sensitivity of FISH is higher than that of urine cytology.As for the low grade urothelial carcinoma,the sensitivity of urine cytology and FISH were 4.8%and 85.7%respectively.And for high grade urothelial carcinoma,the sensitivity of urine cytology and FISH were 14.6%and 87.5%respectively.The receiver operating characteristic(ROC) curve was drawn using the data of sensitivity and specificity,the areas under the curve were 0.55 and 0.913 for urine cytology and FISH.Concerning tumor grade,positive rate of FISH have no relation to malignance,Concerning T-category,similar results were obtained:positive rate have no relation to invasion, Conclusions:FISH is a valuable and not invasive experiment for patients who is suspected to have urothelial carcinoma.The overall sensitivity of FISH is higher than urine cytology, the specificities are the same.Especially for the low grade urothelial carcinomas, while the sensitivity of urine cytology is low,FISH has a much higher sensitivity than urine cytology.With this opportunity,FISH can be a good supplementary.Among the many urine markers used for clinical use,FISH is the one that has both good sensitivity and specificity.Moreover,it's an not invasive process.FISH study of urine exfoliated cells in urothelial tumor was believed to be a very useful tool in the diagnosis of urothelial tumor and in the detection of prognosis and follow-up for urothelial carcinoma.