Detection Of Urothelial Carcinoma Using Fluorescence In Situ Hybridization(FISH) In Patient With Hematauria Suspected Of Urothelial Carcimoma

Objective: To evaluate the clinical significance of fluorescence in situ Hybridization(FISH) technique for screening urothelial carcinoma in patients with hematuria.Methods: A mixture of fluorescent labeled probes to the centromeres of chromosomes3,7and17，and band9p21was used to detect urinary cells for chromosomal abnormalities.From November2010to November2011, Morning urine samples were collected from84patients with hematuria suspected urothelial carcinoma in Fujian Provincial Hospital; allpatients received UCE and FISH respectively. The sensitivity and specificity of both methodswere analyzed statistically. Voided urine samples from10normal individuals were used toestablish the cut-off values. A positive result was defined as the percentage of cells with2ormore abnormal chromosomes was greater than the cut-off values.Results: Of the84patients with hematuria,43had histologically proven urothelial carcinoma. The overall sensitivity of FISH and UCE were81.3％,46.4％,respectively. Thesensitivity of FISH and UCE for non--muscle—invasive (pTa, pTl), was78.6%,42.8%,respectively. The sensitivity of FISH and UCE for invasive（pT2, pT3,pT4）was53.3%,86.6%, respectively. The sensitivity of FISH and UCE for low grade tumors was66.7%and33.4%respectively. The sensitivity of FISH and UCE for high grade tumors Was92％and56％respectively. The specificity of UCE and FISH among patients without evidence ofurothelial carcinoma was88.9%and100%,respectively （P=0.584).Conclusion: The sensitivity of FISH for the detection urothelial carcinoma in patientswith hematuria is superior to that of urinary cytology and the specificity of FISH andcytology for urothelial carcinoma are not significantly different. FISH is a more reliable andless—invasive diagnostic approach for the detection urothelial carcinoma.