Placer José, Espinet Blanca, Salido Marta, Solé Francesc, Gelabert-Mas Antoni
Department of Urology, Hospital del Mar, IMAS, Passeig Maritim 25-29, 08003 Barcelona, Spain.
Eur Urol. 2002 Dec;42(6):547-52. doi: 10.1016/s0302-2838(02)00448-7.
To evaluate the clinical utility of a Multi-color FISH (fluorescence in situ hybridization) assay in voided urine specimens for the detection of bladder cancer and its recurrences, comparing the results with those afforded by urinary cytology.
Voided urine samples from 86 patients were obtained for urine cytology and FISH analysis. The latter was performed using a mixture of fluorescent labeled DNA probes for the centromeric regions of chromosomes 3, 7 and 17, and the 9p21 region. Cystoscopy with biopsy or tumor resection was performed in all patients, comparing the pathological results with the cytological and FISH findings.
Urinary cytology affords an overall sensitivity of 63.8%, the figure being 25% for grade 1, 66.6% for grade 2 and 94.7% for grade 3 tumors. The sensitivities for FISH were 53.3% for grade 1, 83.3% for grade 2 and 100% for grade 3 tumors, with an overall sensitivity of 80.4%. The specificities of urinary cytology and FISH were 86.1 and 85.3%, respectively.
FISH improves the sensitivity rates obtained with urine cytology for bladder cancer detection in all tumor grades and stages, and offers similar specificity. FISH doubles the accuracy of urinary cytology in application to low grade-stage tumors, and detects all high grade infiltrating tumors.
评估多色荧光原位杂交（FISH）检测法在检测膀胱癌及其复发的晨尿样本中的临床效用，并将结果与尿细胞学检测结果进行比较。
收集86例患者的晨尿样本进行尿细胞学和FISH分析。FISH分析采用荧光标记的DNA探针混合物，针对染色体3、7和17的着丝粒区域以及9p21区域。所有患者均接受膀胱镜检查及活检或肿瘤切除术，并将病理结果与细胞学和FISH检查结果进行比较。
尿细胞学检测的总体敏感性为63.8%，其中1级肿瘤的敏感性为25%，2级肿瘤为66.6%，3级肿瘤为94.7%。FISH检测1级肿瘤的敏感性为53.3%，2级肿瘤为83.3%，3级肿瘤为100%，总体敏感性为80.4%。尿细胞学和FISH检测的特异性分别为86.1%和85.3%。
FISH提高了尿细胞学检测在所有肿瘤分级和分期中检测膀胱癌的敏感性，且特异性相似。FISH使尿细胞学检测在应用于低分级低分期肿瘤时的准确性提高了一倍，并能检测出所有高分级浸润性肿瘤。
