Clinical Application Study Of Fluorescence In Situ Hybridization In The Early Diagnosis Of Bladder Urothelial Carcinoma

Objective To investigate the value of fluorescence in situ hybridization(FISH) assay in the early diagnosis of bladder urothelial carcinoma.Methods The threshold of FISH in healthy population was first established. The urine samples of 96 patients suspected with bladder urothelial Carcinoma because of gross or microscopic hematuria, were collected and analyzed by means of cytology and FISH in the Second Affiliated Hospital of Kunming Medical College from October 2010 to April 2011. FISH was used to detect the numerical abnormalities of chromosome 3,7,17 and p16 locus loss. Finally, the results of both methods were compared.Results 58 of 96 patients were diagnosed pathologically with bladder urothelial carcinoma; among,51 were shown to be positive by FISH and 18 by cytology. There was a significant difference(P<0.05) between FISH and cytology in that the sensitivities of FISH and cytology were 87.9% and 31.0% respectively; however, those specificities were 78.9% and 89.5% respectively without significant association (F>0.05). The sensitivities of FISH in non-muscle and muscle invasive bladder urothelial carcinomas were 86.1% and 90.9%. In comparison, those of cytology were 25.0% and 40.9%. There was a significant difference in sensitivity between both methods(P<0.05). Similarly, in low grade cancers The sensitivities of FISH and cytology were 80.0% and 92.1% repectively; in high grade cancers, those of FISH and cytology were 15.0% and 39.5% respectively. There was a significant difference between the two groups(P<0.05). The rates of numerical abnormalities of chromosome 3,7 and 17 were 84.5%,67.2%,79.3%, respectively. The heterozygous loss and homozygous deletion of p16 locus were 22.4% and 29.3%. The p16 homozygous deletions of non-muscle and muscle invasive bladder urothelial carcinomas were 16.7% and 50.0% with a significant association (P＜0.05). The polysomic aberration rates of chromosome 7 and 17 were significantly associated with clinical stages and pathological grades(P<0.05).Conclusions FISH with the advantages of high sensitivity and specificity, is an early and effective diagnosis method to detect bladder urothelial carcinoma in patients with hematuria, and has a broad prospect.