The Research Of Fluorescence In Site Hybridization In Diagnosis And Prognostic Evaluation Of Bladder Cancer

Objective The aim of our experiment is to explain the value of fluorescence in site hybridization (FISH) in diagnosis of bladder cancer, the recurrence of bladder cancer and bladder cancer with hematuria. To discuss the effect of intravesical chemotherapy with epirubicin after operation and the relationship between FISH and the recurrence of bladder cancer,according to the multi-point results of FISH in follow-up.Methods77patients of bladder cancer are included and divided into two groups, initial group (68) and recurrence group (9);10patients who have been excluded urinary system tumor are selected as control group to set up normal range.9patients have been diagnosed with non-tumor and hematuria.FISH has been performed in all patients.Cystoscope or histopathological examination are performed after FISH by pathologist and Urology doctor except10people of control group.11patients of initial bladder cancer are selected after operation as the follow-up group.The operation of bladder cancer is Transurethral Resection of Bladder Tumor (TURBT).Dynamic monitoring FISH was performed before transurethral resection of bladder tumor (TURBT) and at1week,3months and6months after TURBT during intravesical chemotherapy (Epirubicin) with maintenance.The average time of follow-up is6months (5-8M).The drug of intravesical chemotherapy isEpirubicin.Results1> The sensitivity of FISH was75.0%in initial bladder cancer and that of the recurrence bladder cancer was88.9%,there is no statistical significance(p>0.05).while the sensitivity of FISH in different stages (Ta, T1、T2、T3、T4)are62.5%、80.0%、83.3%.84.6%、50.0%separately,and50.0%、100.0%、100.0%in stages (Ta、T1、T2) of the recurrence bladder cancer. 2、Overall sensitivity of bladder carcinoma between G1、G2and G3has not significant difference(p>0.05).There are no significant statistical difference in the different number of tumors and different diameters.3、40patients have been divided into four groups(0%～5%、6%～10%、11%～20%、≥21%) in term of the percentage of positive cells. The accuracy of the groups (0%～5%、6%～10%、11%～20%、≥21%)were55.6%、71.4%、92.3%、100%in diagnosis of bladder cancer, separately. There are significant difference between high Grade bladder cancer and low Grade bladder cancer in percentage of positive cells(p<0.05). But there were no significant difference between Ta、T1and T2in percentage of abnormal cells(p>0.05).4、Overall, the percentage of positive cells has been a downward trend after operation and Epirubicin therapies in following half year. the percentage of positive cells by FISH between pre-operation and1week after TURBT,and between pre-operation and six months after TURBT have a significantly statistical difference(p<0.05);but the percentage of positive cells by FISH between1week and3months,and three months to six months after TURBT have not significantly difference (p>0.05). The percentage of positive cells have no obvious decrease from1week after TURBT to six months after TURBT during epirubicin therapies. two of11patients have the recurrence of bladder cancer less than half a year, and the percentage of positive cells of them are both more than15%,The higher percentage of positive cells leaded to higher rate of tumor recurrence and shorter time of tumor recurrence.Conclusion1. FISH has a high sensitivity in in diagnosis of initial bladder cancer and the recurrence bladder cancer.There is no statistical significance between initial bladder cancer and the recurrence bladder cancer in different stages,grades,numbers and diameters.2. There is an significant difference of percentage of positive cells between high grade tumor and low grade tumors in bladder cancer with hematuria.3. There is a positive relationship between the percentage of positive cells performed by FISH and the incidence rate of bladder cancer with hematuria. 4. FISH will be in favour of monitoring the effect of epirubicin.And the percentage of positive cells have an downward trend with operation and epirubicin therapies during follow-up.There has been a plateau from1week to6months after operation.5. The growth of the percentage of positive cells may be a mark of the recurrence of bladder cancer.