The Study On Clinical Using Of FISH And Cytology In Diagnosis And Surveillance Of Recurrence In UC

Objective:To analyse the diagnostic sensitivity of using fluorescence in situ hybridization (FISH) for detecting both new and recurrent cases of uroepithelial carcinoma (UC) which compared with cytology in routine clinical surveillance and screening of suspicious patients. Because UC has a significant risk of recurrence and progression to invasive disease sensitive way of diagnose and surveillance testing is very important.Methods:Total 43 patients from clinic service and ward with suspicious symptoms or taking the survillien of UC after the operation during Feb.2010 to Nov.2010. The specimen are void urinion and detect by FISH and cytology both. The probe kit was provide by GP Medical Technologies company China. Then the cases whose results is negative in FISH detect, will be made a follow-up at least 6 month , If the reccurrence occur within six month that will be regard as a false-negative result, and after six month as an negative result. The positive results were examined by histological evidence gotted after operation or follow-up, if FISH has a coincident result with and biopsy Then the data will be analysed to detect if the difference is statistical significance.Results:Among 43 patients,24 cases (55.8%) are dignosed UC or tumor recurrence at last. 19 cases (44.2%) find no evidence of tumor or recurrence within at least 6 months follow-up and considered as no UC exist when FISH was detected, 12 cases (27.9%) got the coincidental result of negative, 16 cases (37.2%) were FISH-positive with discordant results on cytology, 6 cases (14.0%) were on the reverse side. Over all, The accuracy of FISH tests from 43 patients is 93.0%(40/43)and cytology is 46.5%(20/43). The sensitivity of FISH is 92.0%(23/25),cytology is 53.3%(8/15),the difference is statistical significance (X~2=5.97,P<0.05). 21 of 24 final diagnosis cases get the histological evidence, 19 of them are FISH positive, 7 (33.3%) with low-grade and 12 (57.1%) with high-grade;and 6 cases are cytology positive which all were high-grade.So FISH's accuracy are higher than cytology in all grade.Conclusion:FISH analysis has a high sensitivity for detecting new cases of UC, as well as recurrences. From the present data FISH is considerably more sensitive and only similar specific than cytology in diagnosing UC. In the routinal clinical using, FISH is effected minor than cytology by infection and hematuria. If FISH used combined with cytology, the accuracy of diagnosis would be raised greately.Then the patience could receive treatment in the earlier period and get the better life quality. Therefore, we recommend FISH as a useful initial diagnostic tool in patients suspected of both new and recurrent UC. But how to raise the sensitivity of FISH in low-grade tumor still need further research.