Yu Jiang, Xiong Hui, Wei Chunxiao, Cui Zilian, Jin Xunbo, Zhang Jianjun
Minimally Invasive Urology Center, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China.
J Cancer Res Ther. 2017;13(4):647-650. doi: 10.4103/jcrt.JCRT_74_17.
The objective of this study was to evaluate the clinical utility of fluorescence in situ hybridization (FISH) in the detection of upper urinary tract-urothelial carcinoma (UUT-UC).
Between November 2011 and November 2015, voided urine specimens from 52 consecutive patients with UUT-UC and 26 controls were collected for both FISH test and cytology. Sensitivity and specificity of FISH test and cytology were determined and compared. The frequency of chromosomal aberrations was also analyzed.
For FISH analysis, the sensitivity was 79.5% and specificity was 96.3%. For cytology, the sensitivity was 27.3% and specificity was 100%. The overall sensitivity for FISH was significantly higher than that of in single value-based urine cytology (79.5% vs. 27.3%, respectively, P < 0.001). The sensitivities of FISH and cytology by grade were 64.3% vs. 28.6% for low-grade urothelial carcinomas (P = 0.128) and 86.7% vs. 26.7% for high-grade urothelial carcinomas (P < 0.001), respectively. Twenty-seven (77.1%) cases were positive due to the gain of two or more chromosomes in five or more urinary cells, among which, 21 (60%) cases showed positivity in all the 4 chromosomes, 7 (20%) cases matched the criterion that 10 or more cells gained a single chromosome, whereas only 1 (2.9%) case was positive because of the homozygous deletion of 9p21 in 12 or more cells.
FISH has superior sensitivity and similar specificity in the detection of UUT-UC, compared with cytology. The present findings indicated that FISH can be applied as a noninvasive diagnostic tool for suspected UUT-UC patients.
本研究旨在评估荧光原位杂交（FISH）在上尿路尿路上皮癌（UUT-UC）检测中的临床应用价值。
2011年11月至2015年11月期间，连续收集52例UUT-UC患者和26例对照者的晨尿标本，进行FISH检测和细胞学检查。确定并比较FISH检测和细胞学检查的敏感性和特异性。同时分析染色体畸变频率。
FISH分析的敏感性为79.5%，特异性为96.3%。细胞学检查的敏感性为27.3%，特异性为100%。FISH的总体敏感性显著高于基于单一值的尿液细胞学检查（分别为79.5%和27.3%，P<0.001）。低级别尿路上皮癌中，FISH和细胞学检查的敏感性分别为64.3%和28.6%（P=0.128）；高级别尿路上皮癌中，FISH和细胞学检查的敏感性分别为86.7%和26.7%（P<0.001）。27例（77.1%）病例因5个或更多尿路上皮细胞中两条或更多染色体增加而呈阳性，其中21例（60%）4条染色体均呈阳性，7例（20%）符合10个或更多细胞获得一条染色体的标准，而仅有1例（2.9%）病例因12个或更多细胞中9p21纯合缺失呈阳性。
与细胞学检查相比，FISH在检测UUT-UC方面具有更高的敏感性和相似的特异性。本研究结果表明，FISH可作为疑似UUT-UC患者的无创诊断工具。
