Clinical Value Of Fluorescence In Situ Hybridization (FISH) In The Screening Of Urothelial Carcinoma In Hematuria

ObjectiveTo assess the clinical value of fluorescence in situ hybridization(FISH) technique in the diagnosis of urothelial cancer, by comparing with color ultrasonography, cytological examination and CT in screening Chinese hematuria patients. The relationship of chromosome aberration between stage of urothelial carcinoma was analized.Methods100 cases were randomly selected from patients with hematuria who hospitalized in The Second Affiliated of Zhengzhou University from Oct,2010 to Feb,2011 and 20 healthy volunteers for research. Fresh morning urine each not less than 200 ml for FISH analysis and urine cytology analysis was collected. Through inspecting 20 cases of volunteer urine specimen by FISH, establish a probe normal threshold, which is using to determine whether the specimens were abnormal. Firstly, morning urine from all patients was collected for FISH test and urine cytology analysis, then all patients were investigated by color ultrasonography and CT, lastly cystoscopy or ureteroscopy examination. Compared every test, which was the best diagnosis of urothelial cancer. Analyzed the correlation of chromosome aberration to TNM stage of urothelial carcinoma.Results1. The sensitivities of FISH test, cytological examination, color ultrasonograph and CT are 86.96%,34.78%,76.09%,69.57%.2. The sensitivity of FISH for the bladder cancer is 87.18%%. The upper urinary tract urothelial carcinoma sensitivity of FISH test is 85.71%. The comparsion of sensitivity of FISH between bladder cancer and upper urinary tract urothelial carcinoma has no significant difference (P>0.05).3. In the non-muscle-invasive cancer group, the sensitivity of FISH test, cytological examination, color ultrasonograph and CT is 84.51%,26.76%,70.42%,61.97%, The difference is significant(P<0.05).4. In the muscle-invasive cancer group, the sensitivity of FISH test, cytological examination, color ultrasonograph and CT is 95.24%、61.90%、95.24%、95.24%, The difference of sensitivity of FISH and cytological examination is significant (P<0.05).5. The total specificity of FISH test, cytological examination, color ultrasonograph and CT is 100%、100%、75%、75%.6. The probability of change of CSP3, CSP 7, CSP 17, and GLPp16 is 63.04%, 64.13%,67.39%,75.00%. The abnormality of four chromosomes in the TNM stage is not significant difference (P>0.05).Conclusions1. The FISH test diagnoses urothelial bladder cancer from genetic level. It is a non-invasive, convenient and safe diagnostic method.2. The FISH test is a non-invasive, convenient and safe method for diagnosing of the upper urinary tract urothelial carcinoma, it decreases the rate of misdiagnosis. It has important clinical value in the diagnosis of the upper urinary tract urothelial carcinoma.3. The FISH test has the highest level of sensitivity in the non-muscle-invasive cancer than urine cytology analysis, color ultrasonography and CT, while they were nearly in the muscle-invasive cancer. The FISH test has the highest level of sensitivity in all great cancer of non-muscle-invasive cancer. The FISH test has the highest level of specificity in urothelial cancer.4. It is special change in 3,7,17 and p16 chromosome in urothelial cancer cells. The abnormality of four chromosomes in the TNM stage is not significant difference (P>0.05).