The Clinical Application Reseach Of Detecting The Molecular Cytogenetics Mutation Of Bladder Neoplasms With Fluorescence In Situ Hybridization

Fluorescence in situ hybridization (FISH) is a kind of nonradioactive molecular cytogenetics technique that developed on the base of the radio- active in situ hybridization technique at the end of 1980s. Comparing with the traditional in situ hybridization technique,it has advantages of fast,high security,sensitivity,examination signal and hybridization specificity and simultaneously it can display many kinds of colors . At present the FISH technology has applied to many biological materials succeessfully, in- cluding the cell, tissue slice, intermediate stage chromosome, high resolu- tion chromosome, separated nucleic acid and so on. even in the cytogenetics, tumor biology, gene mapping, gene amplification, pre-natal diagnosis and research of mammal chromosome evolution ,FISH technology has obtained the widespread application. The bladder neoplasms is the most common tumor in the urinary system. most belongs to the migratory epithelial cell carcinoma. In our country its incidence rate occupies the first place and also has a high rate of palindromia after operation. The cystoscopy brings much pain to the patient. detecting the correlation antigen of bladder neoplasms in urine has a higher sensitivity than cytomorphology test,but its specificity is low. So it cannot be a reliable diadynamic criteria.Objective:The overseas research demonstrated that the FISH tech- nology has a higher sensitivity than exfoliocytology in the diagnosis of bladder neoplasms and the specificity is the same with exfoliocytology. the report that correlating with the Kit Still have not been found in our country . However , chinese hereditary change of bladder neoplasms differ from the people of western countries because the differences exist in physical quality, diet custom ,environment and so on. Therefore, It is necessary to establish data of hereditary change of bladder neoplasms for chinese and explores whether cells in the urine can be also used the to detect hereditary change mentioned above to improve the early diagnosis rate. The purpose of this topic is to provide the theory basis for early diagnosis methods that is non-wound and not painful, and also has high specificity, the high sensitive .Methods: GLPP16/CSP17 (specifical site probe) probe is used in This experiment. 100 fresh urine samples are collected from doubtful bladder neoplasms patients. Then detect the abnormality of 17th chromosome and P16 with exfoliocytology and FISH technology. the cell signal quantity is needed after the probe detection.The sensitivity, specificity and relations with development of bladder neoplasms is analyzed. As the control group, 20 examples are collected from healthy people.Results: The urine of 100 patients who are doubtful to get carcinoma of urinary bladder were detected by GLPP16/CSP17 probe FISH .Analysis result: The positive 77 examples, the false positive 2 examples, the negative 8 examples, the false positive 2 examples, the false negative 11 examples, the suspectable 2 examples, the sensitivity 87.5%, specificity 80.0%. 100 examples carcinoma of urinary bladder doubtful patient's urine were detacted by urine exfoliocytology. result is as follow: The positive 48 examples, the negative 5 examples, the false positive 1 example, the false negative 30 examples, suspect 16 examples. Sensitivity 61.5%, specificity 83.3%. comparing the The FISH technology and exfoliocytology detection, the sensitivity have the significant difference (X2=14.983,P<0.01);but the specificity have no significant differenc(X2=0.0274,P>0.05);the positive rate have the significant difference (X2=17.941,P<0.01)。Ssensitivity of The FISH examination is elevated along with the elevation of graduation of carcinoma of urinary bladder (Tendency examination =4.66,P<0 05)。Conclusion: This study have demonstrated that the diagnosis of the carcinoma of urinary bladde will be more superior to others in sensitivity and specificity by using FISH technology. Although GLPP16/CSP17 will lead to false positive and false negative,it is still a excellent detecting technology because of its high sensitivity and high specificity. Especially there are some shortcomings in exfoliocytology test and cystoscopy .In a word, FISH technology will be a new and excellent detecting technology to increase the early diagnosis rate of bladder neoplasms and detect the prognosise in China.