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

Objective:To investigate the sensitivity and specifity of fluorescence in situ hybridization (FISH) examination in the screening of urothelial carcinoma from gross hematuria, To evaluate the clinical utility of a MultiProbe FISH (fluorescence in situ hybridization, FISH)Assay in Voided Urine Specimens for the detection of Urothelial carcinomas(UC) comparing the results with those afforded by urinary cytology.Methods:The urine samples were collected from100patients whose initial symptoms are Hematuria with suspected urinary bladder neoplasms and30healthy controls.FISH was performed using a mixture of fluorescent labeler DNA Probes for the centromeric regions of chromosomes3,1,17and9P21region. All samples were analyzed by means of FISH and cytology.Results:92cases of pathologically proven for urothelial carcinoma patients, According to the TNM staging system for staging, Non muscle invasive (Ta-T1)52cases, muscle-invasive (T2-T4)40cases, low stage (G1)38cases, high stage (G2-G3)54cases.the overall sensitivity of FISH examination and cytology of bladder carcinoma was84%(77/92) and43%(40/92) respectively.There was significantly difference between low grade/non and high grade/muscle-invasive tumors. The frequency of numerical aberration of chromosomes3、7、9and17was47%,65%,76%and59%respectively.Conclusion:FISH examination was significantly more sensitive than cytology for the diagnose of bladder carcinoma(p<0.05),especially for low grade and low stage urothelial carcinoma (P<0.001). There were no statistically significant differences between the specificity of FISH and cytology of urothelial carcinoma. Abnormality of chromosomes3,7and17was associatedwith the pathological grade(p<0.05) but not associated with the stage of the disease(p>0.05).chromosome9was not correlated with pathological grade of urothelial carcinoma and stage of the disease,but it is related with the occurrence of bladder cancer. FISH can promote the diagnosis of unexplained hematuria, it may be a new promising non-invasive method for the diagnosis of unexplained hematuria and UUC.