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

Objective:To establish the experimental platform of Fluorescence in situ hybridization(FISH) in detecting urothelial carcinoma.Detect the chromosome abnormalities in the urine cells of patients with urothelial carcinoma.To discuss the value of FISH as a non-invasive diagnosis method for urothelial carcinoma.Methods:Urine samples of both suspected urothelial carcinoma patients and healthy controls were collected,urine cytology and FISH were synchronously checked.FISH were used to detect the abnormalities of chromosome 3,7,17 and 9p21(p160.100 suspected patients of urothelial carcinoma and 20 healthy controls were enrolled in this experiment.Data of the healthy group were collected to establish the threshold and patients of carcinoma were diagnosed by this threshold.Through the comparison and statistical analysis between the results of the experiments and pathology,we concluded the sensitivity and specificity of the two methods,as well the difference between high grade and low grade carcinomas.Results:Urine samples of patients with urothelial carcinoma have obviously increased chromosome abnomilities compared with the control group.After the threshold were established,results of FISH and urine cytology were compared.The sensitivity and specificity of urine cytology were 71%and 80%respectively,the sensitivity and specificity of FISH were 88%and 80%respectively,the sensitivity of FISH is higher than urine cytology.As for the low grade urothelial carcinoma,the sensitivity of urine cytology and FISH were 49%and 78%respectively.And for high grade urothelial carcinoma,the sensitivity of urine cytology and FISH were 88%and 96% respectively.The receiver operating characteristic(ROC) curve was drawn using the data of sensitivity and specificity,the areas under the curve were 0.758 and 0.842 for urine cytology and FISH.Conclusions:FISH is a valuable and non-invasive experiment for patients who is suspected to have urothelial carcinoma.The overall sensitivity of FISH is higher than urine cytology, the specificities are the same.Especially for the low grade urothelial carcinomas, while the sensitivity of urine cytology is low,FISH has a much higher sensitivity than urine cytology.With this opportunity,FISH can be a good supplementary.Among the many urine markers used for clinical use,FISH is the one that has both good sensitivity and specificity.Moreover,it's an non-invasive process.FISH has considerable value in the diagnosis and follow-up for urothelial carcinoma.