Detection Of Urothelial Carcinoma By DNA Image Cytometry

Research purposes: DNA image cytometry technology has been widely applied in the early diagnosis and screening of cervical cancer,lung cancer,esophageal cancer and other cancers since its appearance.Most of the early urothelial carcinoma patients are lack of obvious symptoms and signs,the majority of urothelial carcinoma patients are diagnosed after the occurrence of hematuria or in the physical examination.There are no accurate urothelial cancer screening methods,so we study the application of automatic DNA image analysis technique in the diagnosis of urothelial carcinoma.Methods: We analyzed the DNA image of urine exfoliative cells in 177 patients in 2014~2017.Age,sex,tumor grade,initial symptoms,recurrence,liquid based cytology,DNA image cytometry,postoperative pathological data were collected.Results: A total of 177 cases were collected,including 103 patients with urothelial carcinoma,67 patients with non urothelial carcinoma and 7 patients with renal cell carcinoma.The average age was 70.26 + 12.10 years,including 142 males and 35 females.The results showed that the sensitivity and specificity of DNA-ICM for diagnosis of urothelial carcinoma were 63.11% and 95.52%.When combined with liquid based cytology,the sensitivity was increased to 92%.For high-grade and low-grade urothelial carcinoma,the diagnostic sensitivity was 77.78% and 29.03%.For upper urinary tract and lower urinary tract urothelial carcinoma,the diagnostic sensitivity was 60% and 63.64%.The diagnostic sensitivity of 81 patients with hematuria and 22 patients without hematuria was 61.73% and 68.18%.Of the 7 cases of renal carcinoma,4 cases were infringed on the urinary tract,of which 3 were detected by DNA-ICM.Conclusion: DNA-ICM has a high detection efficiency in the diagnosis of urothelial carcinoma,especially for high-grade urothelial carcinoma.The location of urothelial carcinoma and hematuria had no significant effect on the accuracy of DNA-ICM.It has the advantages of high accuracy,easy operation,low cost and so on.However,its detection efficiency for low-grade urothelial carcinoma is still worthy of improvement,and it can be improved by combining with other methods of urine tumor detection.Whether it can be used as a screening tool for urothelial carcinoma or as the first choice before cystoscopy,further large sample randomized study is needed.