The Use Of Fluorescence In Situ Hybridization To Predict Response To Epirubicin Intravesical Instillation Therapy For Bladder Cancer

Objective:Use of Fluorescence In Situ Hybridization in patients with Epirubicin instillation therapy for bladder cancer to research the relationship between the FISH resutls with tumor recurrence and progress.Methods:Candidates for standard of epirubicin intravesical instillation therapy were offered participation in a clinical trial. Fluorescence in situ hybridization was performed before epirubicin, at1month and3months during epirubicin therapy with maintenance. Assess the relationship between fluorescence in situ hybridization results and tumor recurrence or progression.Results:1. A total of43patients participated in the study, male41cases (95.3%), female2cases (4.7%),with average age of63.7years. At a median followup of21.3months34.9%(15cases) of patients had recurrent tumors and14.0%(6cases) experienced disease progression.2. In the process of Epirubicin intravesical instillation therapy after TUR, each observation point of FISH results in patients with positive results has a higher rate of tumor recurrence and tumor progression than patients with negative results.For patients with positive FISH results before epirubicin and at1month, the tumor recurrent rate were48.3%VS.7.1%(P=0.021) and56.3%VS.22.2%(P=0.024) respectively,with significant statistically difference; for patients with positive FISH results at3months, the tumor recurrent rates were42.1%VS.29.2%(P=0.377),with no significant statistically difference.Patients who had positive fluorescence in situ hybridization results also more likely to have disease progression.For patients with positive FISH results at1month, the tumor progression rates were31.3%VS.3.7%(P=0.039), with significant statistically difference,for patients with positive FISH results before epiru-bicin and at3months, the tumor progression rates were20.7%VS.0%(P=0.172) and26.3%VS.4.2%(P=0.101) respectively,with no significant statistically difference. 3. According to the preset observation points, three FISH detection were completed in all patients, analysis the relationship between the number of positive FISH results of each patient with tumor recurrence and progress. For patients with1time,2times and3times of positive FISH results, the tumor recurrence rates were36.4%(4/11),46.2%(6/13) and55.6%(5/9), P>0.05, with no statistical difference; The tumor progression rates were0%(0/11),15.4%(2/13) and44.4%(4/9), P<0.05, with significant statistically difference.4. Patients who had a positive FISH result at1month and3months after the process of continuous Epirubicin Intravesical instillation were more likely to have regression tumors than those who had negative results at both times.The tumor recurrence rates were55.6%and17.6%, P=0.078, with no statistical difference; The tumor progression rate were44.4%and0%respectively, P=0.008, with significant statistically difference.Conclusion:1. In the process of continuous Epirubicin Intravesical instillation, The FISH test results at1month has a reliable value in predicting tumor recurrence and progress. Patients who had positive fluorescence in situ hybridization results is not sensitive to treatment, and face a higher risk of tumor recurrence and progression.This information may be used to counsel patients about alternative treatment strategies.2. Patients with multy times (3times or2times) positive FISH results have a larger risk of tumor progression than patients with a single posibive FISH result, but there was no significant difference in the risk of tumor recurrence.3. Patients who had a positive FISH result at1month and3months after the process of continuous Epirubicin Intravesical instillation were more likely to have regression tumors than those who had negative results at both times, but there was no significant difference in the risk of tumor recurrence.