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Asian J Urol. 2019 Jan;6(1):114-121. doi: 10.1016/j.ajur.2018.06.001. Epub 2018 Jun 8.

Application of fluorescence in situ hybridization in the detection of bladder transitional-cell carcinoma: A multi-center clinical study based on Chinese population.

Zhou L1,2,3, Yang K1,2,3, Li X1,2,3, Ding Y1,2,3, Mu D4, Li H5, Yan Y6, Li J7, Wang D8, Li W9, Cong Y10, Gao J10, Ma K11, Xiao Y12, Zhang S13, Jiang H14, Hu W15, Wei Q16, Jin X17, Guan Z18, Liu Q19, Xu D20, Gao X21, Jiang Y22, Gan W23, Sun G24, Wang Q25, Liu Y26, Hou J27, Xie L28, Song X29, Jin F30, Feng J31, Cai M32, Liang Z33, Zhang J34, Ye D35, Qi L36, Ma L37, Shou J38, Dai Y39, Shao J40, Tian Y41, Hong S42, Xu T43, Kong C44, Kang Z45, Liu Y46, Qu X47, Shi B47, Zheng S48, Lin Y49, Xia S50, Wei D51, Wu J52, Fu W53, Wang Z54, Liang J55.

Author information

1
Department of Urology, Peking University First Hospital, Beijing, China.
2
Institute of Urology, Peking University, Beijing, China.
3
National Urological Cancer Center, Beijing, China.
4
Air Force General Hospital, PLA, Beijing, China.
5
Department of Urology, Peking Union Medical College Hospital, Beijing, China.
6
Department of Urology, Beijing Chao-Yang Hospital, Beijing, China.
7
Department of Urology, Armed-Police General Hospital, Beijing, China.
8
Department of Urology, Shanxi Medical University First Hospital, Taiyuan, China.
9
Department of Urology, Hebei Medical University Second Hospital, Shijiazhuang, China.
10
Department of Urology, The General Hospital of the People's Liberation Army, Beijing, China.
11
Department of Urology, First Affiliated Hospital of Jilin University, Changchun, China.
12
Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
13
Department of Pathology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
14
Department of Urology, The Second Xiangya Hospital of Central South University, Changsha, China.
15
Department of Urology, General Hospital of Guangzhou Military Command of PLA, Guangzhou, China.
16
Department of Urology, West China School of Medicine, Chengdu, China.
17
Department of Urology, Shangdong Province-owned Hospital, Jinan, China.
18
Department of Urology, Peking University Shenzhen Hospital, Shenzhen, China.
19
Department of Urology, The Central Hospital of Jinan City, Jinan, China.
20
Department of Urology, Shanghai Changzheng Hospital, Shanghai, China.
21
Department of Urology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
22
Department of Urology, Beijing Anzhen Hospital of Capital Medical University, Beijing, China.
23
Department of Urology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
24
Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China.
25
Department of Urology, People's Hospital of Xinjiang Uygur Autonomous Region, Wulumuqi, China.
26
Department of Urology, Guangdong General Hospital, Guangzhou, China.
27
Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, China.
28
Department of Urology, The First Hospital of Zhejiang Province, Hangzhou, China.
29
Department of Urology, The First Affiliated Hospital of Dalian Medical University, Dalian, China.
30
Department of Urology, Daping Hospital, Research Institute of Surgery, Third Military Medical University, Chongqing, China.
31
Department of Urology, Mianyang Central Hospital, Mianyang, China.
32
Department of Urology, General Hospital of PLA General Staff Headquarters, Beijing, China.
33
Department of Urology, First Affiliated Hospital of Anhui Medical University, Hefei, China.
34
Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China.
35
Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China.
36
Department of Urology, Xiangya Hospital of Central South University, Changsha, China.
37
Department of Urology, Peking University Third Hospital, Beijing, China.
38
Department of Urology, Cancer Hospital of Chinese Academy of Medical Sciences, Beijing, China.
39
Department of Urology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
40
Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, China.
41
Department of Urology, Beijing Friendship Hospital of Capital Medical University, Beijing, China.
42
Department of Urology, Wenzhou Central Hospital, Wenzhou, China.
43
Department of Urology, Peking University People's Hospital, Beijing, China.
44
Department of Urology, The First Hospital of China Medical University, Shenyang, China.
45
Department of Urology, Qinghai Province People's Hospital, Xining, China.
46
Department of Urology, Beijing Tongren Hospital of Capital Medical University, Beijing, China.
47
Department of Urology, Qilu Hospital of Shandong University, Jinan, China.
48
Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
49
Department of Urology, Tianjing Medical University General Hospital, Tianjin, China.
50
Department of Urology, Shanghai General Hospital, Shanghai, China.
51
Department of Urology, Beijing Hospital, Beijing, China.
52
Department of Urology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
53
Department of Urology, Southwest Hospital, Chongqing, China.
54
Department of Urology, Lanzhou University Second Hospital, Lanzhou, China.
55
Department of Urology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.

Abstract

Objective:

To evaluate the diagnostic value of fluorescence in situ hybridization (FISH) in bladder cancer.

Methods:

We enrolled healthy volunteers and patients who were clinically suspected to have bladder cancer and conducted FISH tests and cytology examinations from August 2007 to December 2008. Receiver operating characteristic (ROC) curve analysis was performed and the area under curve (AUC) values were calculated for both the FISH and urine cytology tests.

Results:

A cohort of 988 healthy volunteers was enrolled to establish a reference range for the normal population. A total of 4807 patients with hematuria were prospectively, randomly enrolled for the simultaneous analysis of urine cytology, FISH testing, and a final diagnosis as determined by the pathologic findings of a biopsy or a surgically-excised specimen. Overall, the sensitivity of FISH in detecting transitional-cell carcinoma was 82.7%, while that of cytology was 33.4% (p < 0.001). The sensitivity values of FISH for non-muscle invasive and muscle invasive bladder transitional-cell carcinoma were 81.7% and 89.6%, respectively (p = 0.004). The sensitivity values of FISH for low and high grade bladder cancer were 82.6% and 90.1%, respectively (p = 0.002).

Conclusion:

FISH is significantly more sensitive than voided urine cytology for detecting bladder cancer in patients evaluated for gross hematuria at all cancer grades and stages. Higher sensitivity using FISH was obtained in high grade and muscle invasive tumors.

KEYWORDS:

Bladder transitional-cell carcinoma; Detection; Fluorescence in situ hybridization; Grade; Stage

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