The Application Value Of Fluorescence In Situ Hybridization In The Diagnosis Of Urothelial Carcinoma

Background and Objective:Urinary tract epithelial carcinoma is a malignant tumor originating from the urinary tract,including renal pelvic urothelial carcinoma,ureter urothelial carcinoma and bladder urothelial carcinoma.Among them,the incidence of bladder urothelial carcinoma is the highest.Biopsy is the gold standard for the diagnosis of urothelial carcinoma by ureteroscope or cystoscope.However,both are invasive examination.Patients are unwilling to accept,and after the examination gross hematuria,urination pain and other complications are easy to appear.Therefore,to find a noninvasive and effective method for patients who were suspected urothelial carcinoma whether early screening,adjuvant diagnosis,recurrence monitoring,or to reduce the number of invasive examination is of great significance.At present,urine cytology is a routine non-invasive examination method,and its specificity is high,but the sensitivity is not the best.With the continuous deepening of the research on the genetics of the urinary tract epithelial cancer,it has been confirmed that the aneuploidy for chromosomes 3,7,17,and loss of the 9p21 locus are closely related to the occurrence ofurothelial carcinoma.According to a lot of reports in the literature,the specificity of fluorescence in situ hybridization(FISH)technique is similar to urine cytology,but the sensitivity is obviously higher.This study intends to discuss the application value of fluorescence in situ hybridization in diagnosis of urothelial carcinoma.Methods:Acquired urine specimens from the patients who were suspected urothelial carcinoma.FISH was performed using a mixture of fluorescent labeled DNA probes for the centromeric regions of chromosomes 3,7 and 17,and the 9p21 region,also analyzed by urine cytology.The pathological results were the gold standard for the diagnosis of urothelial carcinoma.Then the application value of FISH in the diagnosis of urothelial carcinoma was evaluated and compared with urine cytology.Results : Collected a total of 111 patients,and 6 cases was eliminated due to incomplete data.The pathological results in the remaining 105 cases were confirmed as 80 cases of urothelial carcinoma.The FISH was detected positive in 62 cases,negative in18 cases,and the urine cytology was positive in 19 cases,negative in 61 cases.The patients of non urinary tract epithelial cancer were25 cases.Among them,FISH test was positive in 3 cases,negative in 22 cases,and urine cytology examination was positive in 0 cases,negative in 25 cases.The sensitivity of FISH detection was 77.50%,specificity was 88%,and the sensitivity of urine cytology was 23.75%,the specificity was 100%.Conclusion:FISH has similar specificity compared with urine cytology,but the sensitivity was significantly higher than that of urine cytology.As a non-invasive and effective detection technology,FISH assay has an important clinical significance and practical value in assisting in the diagnosis of urothelial carcinoma.