Jin Hongyu, Lin Tianhai, Hao Jianqi, Qiu Shi, Xu Hang, Yu Ruichao, Sun Sheng, Zhang Peng, Liu Zhenhua, Yang Lu, Liu Liangren, Han Ping, Wei Qiang
Department of Urology, Institute of Urology, West China Hospital, Sichuan University.
West China School of Medicine, Sichuan University, Chengdu, Sichuan Province, China.
Medicine (Baltimore). 2018 Dec;97(52):e13859. doi: 10.1097/MD.0000000000013859.
To compare the relative effectiveness of fluorescence in situ hybridization (FISH) and cytology in diagnosing upper urinary tract urothelial carcinoma (UUT-UC) and to evaluate the advantages and potential deficiencies of FISH analysis.
We performed a complete systematic review based on studies from PubMed/Medline, Embase, Web of Science, Ovid, Web of Knowledge, and Cochrane Library. We identified 2031 patients with strict criteria in 14 individual studies between January 2005 to November 2017 in accordance to preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines, we summarized the test performance using bivariate random effects models.
FISH was superior to cytology in terms of pooled sensitivities (84.0%, 95% confidence interval [CI] 74.4-90.5% vs 40.0%, 95% CI 33.6-46.7%). FISH and cytology were similar to each other in terms of pooled specificities, which were 89.5% (95% CI 85.3-92.6%) for FISH and 95.9% (95% CI 91.2-98.1%) for cytology.
We confirm the superiority of FISH over cytology in terms of sensitivity and find similar diagnostic outcomes between them based on systematic analysis. Therefore, we demonstrate that FISH is extremely sensitive while still very reliable with a relatively low error rate for diagnosing UUT-UC.
比较荧光原位杂交（FISH）和细胞学检查在上尿路尿路上皮癌（UUT-UC）诊断中的相对有效性，并评估FISH分析的优势和潜在不足。
我们基于来自PubMed/Medline、Embase、Web of Science、Ovid、Web of Knowledge和Cochrane图书馆的研究进行了全面的系统评价。根据系统评价和Meta分析的首选报告项目（PRISMA）指南，我们在2005年1月至2017年11月期间的14项独立研究中确定了2031例符合严格标准的患者，我们使用双变量随机效应模型总结了检测性能。
FISH在合并敏感度方面优于细胞学检查（84.0%，95%置信区间[CI]74.4-90.5%对40.0%，95%CI 33.6-46.7%）。FISH和细胞学检查在合并特异度方面彼此相似，FISH为89.5%（95%CI 85.3-92.6%），细胞学检查为95.9%（95%CI 91.2-98.1%）。
我们通过系统分析证实了FISH在敏感度方面优于细胞学检查，并发现它们之间的诊断结果相似。因此，我们证明FISH在诊断UUT-UC时极其敏感，同时仍然非常可靠，错误率相对较低。
