The Clinical Application of Fluorescence in Situ Hybridization in Diagnosing Urothelial Carcinoma.

BACKGROUND: Chromosomal aberrations in exfoliated urothelial cells have been associated with the development of urothelial carcinoma. This study aimed to evaluate the efficacy of two kinds of fluorescence in situ hybridization (FISH) kit probes in diagnosing urothelial carcinoma (UC).

METHODS: From February 2009 through September 2014, urine specimens from 89 consecutive patients with urothelial carcinoma and 11 controls with benign disease were collected and analyzed by means of GP FISH and cytology. Urine samples from 50 consecutive patients with urothelial carcinoma and 68 patients with non-urothelial carcinoma with hematuria were also collected and analyzed by UroVysion FISH and cytology. The sensitivity and specificity of two kinds of FISH and cytology in different stages and grades of urothelial carcinoma were statistically analyzed via SPSS 17.0 and compared.

RESULTS: The overall sensitivity of GP FISH and cytology were 88.8% (79/89) and 55.1% (49/89), respectively (p < 0.001), and the overall specificity was 90.9% (10/11) and 100.0% (11/11), respectively (p > 0.05). The overall sensitivity of UroVysion FISH and cytology was 68.0% and 18.0%, respectively (p < 0.05), and the overall specificity was 91.2% and 98.5%, respectively (p > 0.05). The sensitivity of FISH and cytology in diagnosing UUT-UC were 88.9% (16/18) and 44.4%(8/18),respectively. The sensitivity of GP FISH and UroVysion FISH in diagnosing UUT-UC were 100% (10/10) and 75.0% (6/8) respectively.

CONCLUSIONS: FISH is a non-invasive technique with higher sensitivity and similar specificity compared with urine exfoliated cell cytology in diagnosing urothelial carcinoma by detecting the aberrations of chromosome 3, 7, 17, and 9p21. FISH is significantly superior to cytology in diagnosing low stage and low grade urothelial carcinomas. FISH is a very valuable and promising technique in diagnosing urothelial carcinomas.