Application And Discussion Of Positive Fluorescence In Situ Hybridization Of Voided Urine Specimens In Urinary Tract-urothelial Carcinoma

Urothelial carcinoma is the most common type of malignant tumor in the urinary system,among which bladder urothelial carcinoma has the highest incidence,accounting for more than 90%.Among newly developed male tumor patients,the rate of bladder cancer accounts for 7%,which is second only to prostate cancer among malignant tumors in the urinary system.According to the statistics,the incidence of urothelial carcinoma in Asian population increases year by year,and the incidence increases with age.The clinicopathological grading and staging of the urothelial carcinoma are significant risk factors that affecting the prognosis.Therefore,early detection,diagnosis and treatment are particularly important for reducing recurrence risk,supervising prognosis and alleviating pressures on patients.During the generation and development of tumors,the genomic changes of tumor cells are earlier than the morphological changes.As an new diagnostic method,fluorescence in situ hybridization(FISH)can detect the genetic changes of tumor cells at an early stage so that provide possibilities for the "early detection,diagnosis and treatment" of tumors.This paper aims to evaluate the significance of FISH in urothelial carcinoma by retrospective analysis.Objective:The objective of this research was to evaluate the significance of positive FISH in urothelial carcinoma by analyzing the aberration of chromosomes of voided urine specimens with FISH.Methods:The clinical data of 160 patients with positive FISH test results and confirmed by pathology were selected from 850 patients who underwent FISH detection in the urological minimally invasive center of Shandong provincial hospital from August 2012 to December 2017,and their clinicopathological characteristics were summarized.The chromosomal aberrations of urinary epithelial carcinoma cells were detected by FISH,and the staging and grading of tumors were compared by chi-square test,so as to explore the clinical value and significance of fluorescence in situ hybridization of urine exfoliated cells in urinary epithelial carcinoma.Results:1.Of the 160 patients,the proportion of male patients is significantly higher than that of female patients.Hematuria is the most common reason in patients with urothelial neoplasm.In patients with hematuria,the positive predictive value(PPV)of FISH for the diagnosis of urothelial carcinoma was 63.1%in this study.2.In the correlation analysis between tumor type and tumor pathological grading,there was ino statistical difference between ureteral cancer,renal pelvis cancer and bladder cancer.In the correlation analysis between tumor type and tumor staging,there were significant differences among different tumor types.3.CSP3,CSP7,CSP17 and GLPp16 FISH tests showed high aberration rate in urothelial carcinoma.CSP3,CSP7,CSP17 mutations had no statistical difference in the different tumor types,aberration of p16 loci of chromosome9(including missing and amplification)also had no statistical difference in different types of tumors.4.There was no statistical difference in different mutation types of CSP3,CSP7,CSP17detected by FISH and pathological grades.There was a statistical difference GLPp16 and pathological grading.There was no statistical difference in chromosome mutation type and pathological stage.Conclusion:FISH detection of urinary exfoliated cells can be used as a non-invasive diagnostic tool for urothelial carcinoma,which has high application value in the early screening,diagnosis and recurrence monitoring of urothelial carcinoma.In addition,the occurrence of chromosome 9 mutations and the differences in the types of mutations can be used as a test indicator to evaluate the grade of urothelial carcinoma.