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Objective: To compare fluorescence in situ hybridization (FISH) and urine cytology sensitivity and specificity in the diagnosis of bladder cancer, evaluation of FISH technique in the diagnosis of bladder cancer in value. Method: the Second Hospital of Hebei Medical University Urology hematuria suspected bladder cancer patients were treated in 100 cases from April 2008 to December 2008 for the study, including 24 cases of bladder transitional cell cancer history and 76 patients without history of bladder cancer. 20 cases of normal control. Fluorescence in situ hybridization (fluorescence in situ hybridization, FISH) is an application of the non-radioactive fluorescent substance to rely on the principle of nucleic acid hybridization method to display the location of the DNA sequences in the chromosomes, with a rapid, noninvasive, sensitivity advantages in the medium term and interphase cells could be detected in the DNA sequence and its changes. This technology is widely used in the field of tumor biology, cytogenetics, gene mapping, gene amplification. Fluorescence in situ hybridization can be detected for the different cell types of genetic changes, including chromosome replication, amplification, deletion and so on. FISH probes used in this study include a combination of: the GLP of P16 a probe / CSP 17 probe, P16 probe name for the cyclin-dependent kinase inhibitor 2A; CSP 17 probe name for chromosome 17 centromere . P16 probe hybridization to human chromosome 9 long arm (9q21), covering the entire p16 gene, the fluorescence signal is red; CSP 17 control probe hybridization signal is located on human chromosome 17 centromere (17p11.1-q11 .1), covering the whole centromere region, the fluorescence signal is green. 120 urine samples collected 100 cases of hematuria suspected bladder cancer patients and 20 normal people of different ages, using fluorescently labeled chromosome 17 centromere and 9q21 the zone probe to detect urine exfoliated epithelial cells chromosomes abnormal . FISH detected by normal urine of 20 patients with different age, and 9q21, 17 chromosomes were counted 100 cells, the statistics of the number of cells of different types of abnormal situations, and so established threshold. Meanwhile, 100 suspected cases of bladder cancer patients with hematuria line FISH detection count, using the method described above on the different types of abnormal cells, respectively, compared with a threshold value to determine the chromosomal abnormality. The FISH testing positive standard 9q21 were abnormal in 17 chromosome or a chromosome at the same time there are missing or increased. Meanwhile, the line of 100 suspected cases of bladder cancer patients with hematuria urine cytology cytology specimens for FISH testing specimens taken on the same day, get 3 consecutive times. The results are divided into positive, negative, suspicious. Cytology suspicious, but difficult to diagnose bladder cancer, positive treatment in the calculation of sensitivity. Staging of bladder cancer were counted FISH and cytology positive cases, using statistical methods to compare the two different stages of tumor sensitivity and overall specificity. Urine samples need to be taken before cystoscopy suspected cases to biopsy or excision, histopathological diagnosis of tumor staging. Results: A total of 93 patients were pathological diagnosis of bladder or upper urinary tract transitional cell carcinoma. FISH on different stages of bladder cancer pTis / pTa (22 cases) was pT1 or (52 cases), pT2 (14 cases) and pT3/pT4 (5 cases) diagnostic sensitivity of 54.55%, 88.46%, 92.86%, and 100 %. Cytology for the different stages of bladder cancer pTis / pTa (22 cases), pT1 (52 cases), pT2 (14 cases) and pT3/pT4 (5 cases), the diagnostic sensitivity of 22.72%, 38.46%, 78.57%, respectively and 100%. Of bladder cancer pTis / pTa phase (P = 0.030), pT1 bladder cancer (P = 0.001), pT2 bladder cancer (P = 0.596), pT3/pT4 of bladder cancer (P gt; 0.05). FISH overall sensitivity of 81.72%, the overall sensitivity of cytology was 44.09% (P = 0.001), and the specificity of FISH and cytology 85.71% and 100%, respectively (P = 0.299). Conclusion: FISH is used to detect bladder cancer patients with hematuria sensitive than urine cytology, specificity was no significant difference. The FISH technique can significantly improve the diagnosis of bladder cancer, bladder cancer screening significance. This study non-invasive bladder cancer for the Chinese population, with high specificity and provide a theoretical basis for the establishment of the highly sensitive method of early diagnosis.
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