The Clinical Application Of Fluoresence In Situ Hybridization In Diagnosis Of Urothelial Bladder Cancer

Bladder cancer is the most common urinary system of malignant tumor, in our country of genitourinary system tumor, the Urothelial bladder cancer are accounted for first place, and increasing year by year. Early diagnosis for the effective treatment is important. At present, The diagnosis of urothelial carcinoma rely mainly on cystoscopy, imaging examination, and cytology, the diagnosis rely on cystoscopy and histopathologic examination. But cystoscopy is invasive test, Patients are not easy to accept, the sensibility of imaging study and cystoscopy are both low. So, looking for a kind of objective and noninvasive diagnosis method with high sensitivity and Specificity, is the key to improve the urothelial carcinoma diagnostic and reduce mortalityObjective:To estimate the value of fluorescence in situ hybridization (FISH) in diagnosis of urothelial bladder cancer.Methods:Twenty specimens were obtained from healthy people. Using directly labeled DNA probes of the3rd,7th,17th and P16dot at9th chromosome to detect the exfoliated urothelial cells in the urine. And get the threshold value of healthy adult. Fresh urine samples from158patients suspect of carcinoma of bladder were collected and examined by cytology and fish simultaneously before cystoscopy. The sensitivity, specificity, positive predictive value and negative predictive value of FISH and cytology were analyzed.Results:The sensitivity of FISH and Cytology was84.8%and43.8%. The sensitivity of FISH was prior to that of Cytology (p<0.05), the specificity of FISH and Cytology was89.1%and87.0%, there was on difference between them (P>0.05).The positie predictie alue of FISH and Cytology was95.0%and89.1%. there was on difference between them (P>0.05). the negatie predictie alue of FISH and Cytology was70.7%and38.8%, the negatie predictie alue of FISH was prior to that of Cytology (x2=15.06, P<0.01). In the different tumor pathology classification, The sensitivity of FISH and Cytology was60.0%and12.0%in Grade1; The sensitivity of FISH and Cytology was90.9%and51.5%in Grade2; The sensitivity of FISH and Cytology was95.2%and57.1%in Grade3. Increased with increasing tumor pathologic grade, FISH have a higher sensitivity than cytology, and increased with increasing tumor pathologic grade (P<0.05). Conclusions:In diagnosing urothelial bladder cancer, the sensitivity of FISH which use directly labeled DNA probes of the3rd,7th,17th and P16dot at9th chromosome to detect the exfoliated urothelial cells in the urine is better than Cytology, but the specificity is close to Cytology, and the positie predictie alue is better than Cytology, negatie predictie alue close to Cytology. FISH may be a simple, noinvasive, high specificity and sensitivity method to screen and diagnose bladder cancer, it has the important value of clinical application, and is expected to replace Cytology.