尿膀胱癌抗原、透明质酸和存活素联合应用对膀胱癌的诊断价值

目的评价联合运用尿膀胱癌抗原(UBC)、透明质酸(HA)和存活素诊断膀胱癌的临床应用价值。方法64例膀胱癌患者、20例泌尿系良性疾病患者在膀胱镜检查前留尿,分别进行UBC、HA、存活素和脱落细胞学检测,比较4种方法诊断膀胱癌的价值。膀胱癌患者肿瘤分级G_1 11例,G_2 38例,G_3 15例；病理分期pT_(is) 2例,pT_1 36例,pT_1 16例,≥pT_2 10例。结果UBC、HA和存活素诊断膀胱癌的敏感性分别为85.9%(55/64)、89.1%(57/64)、93.8%(60/64),与脱落细胞学(40.6%)比较,差异有统计学意义(P＜0.01),4种方法诊断膀胱癌的特异性分别为85.0%(17/20)、80.0%(16/20)、95.0%(19/20)和95.0%(19/20)。各分级和分期UBC、HA和存活素诊断膀胱癌的敏感性均高于尿脱落细胞学检查；UBC值各分级和分期比较差异无统计学意义(P＞0.05)。HA检测值G_2、G_3组均明显高于G_1组(P＜0.01),但G_2、G_3组间比较差异无统计学意义(P＞0.05)；各分期之间比较差异无统计学意义(P＞0.05)。存活素检测各分级和分期之间比较差异无统计学意义(P＞0.05)。而对尿细胞学来说,肿瘤分级越高,敏感性越高(P＜0.01),各分期之间比较差异无统计学意义(P＞0.05)。联合应用UBC、HA和存活素诊断膀胱癌的敏感性和特异性均达到100%。结论尿中UBC、HA和存活素是早期诊断膀胱癌的较好肿瘤标记物,3项检测联合能提高诊断的敏感性和特异性。     

尿膀胱癌抗原与透明质酸在膀胱癌诊断中的临床价值

目的　评价尿膀胱癌抗原 (UBC)和透明质酸 (HA)诊断膀胱癌的价值。　方法　研究对象 94例 ,其中膀胱癌患者 64例 ,泌尿系良性疾病患者 2 0例 ,健康对照组 10例。膀胱镜检查前取尿样分别进行UBC、HA和脱落细胞学检测 ,分析比较 3种方法的敏感性、特异性、阳性和阴性预测价值。　结果　以 12 μg/L为UBC诊断膀胱癌的临界值 ,以大于正常对照组尿液HA水平上限 14 4 .7ng/ml为HA阳性界值时 ,UBC和HA诊断膀胱癌的敏感性分别为 85.9%和 89.1% ,与脱落细胞学 (40 .6% )比较 ,差异有显著性意义 (P <0 .0 1) ,3种方法诊断膀胱癌的特异性分别为 85.0 %、80 .0 %和 95.0 % ,阳性预测值分别为 94.8%、93 .4%和 96.3 % ,阴性预测值分别为 65.4%、72 .7%和 3 3 .3 %。　结论　尿UBC和HA检测技术简单 ,有较高的敏感性和特异性 ,可作为早期诊断膀胱癌的较好的肿瘤标记物。     

多靶位荧光原位杂交技术对上尿路尿路上皮癌诊断的应用价值

目的:比较多靶位荧光原位杂交技术(M-FISH)、尿脱落细胞学对上尿路尿路上皮细胞癌(UTUC诊断的临床研究。方法:30例正常健康人通过FISH检测3、7、l7号染色体非整倍性及9号染色体p16位点缺失等变异情况,确立阈值。同时收集101例影像学初步怀疑UTUC患者的尿液标本,行FISH检测和尿脱落细胞学检查,以手术病理结果为金标准,比较FISH、尿脱落细胞学检查对UTUC诊断的敏感度及特异度。结果:FISH、尿脱落细胞学检查对UTUC诊断的敏感度分别为78.9%(71/90)和38.9%(35/90),差异有统计学意义(P0.05);特异度为90.9%(10/11)和90.9%(10/11),差异无统计学意义(P0.05)。结论:与尿脱落细胞学检查相比,FISH对UTUC诊断有更高的敏感度和相似的特异度,是对UTUC进行早期无创伤性诊断的有效手段。     

晨起第一次新鲜中段尿用于膀胱癌细胞学诊断的临床价值

目的 探讨晨起第一次中段尿脱落细胞学检查诊断膀胱癌的临床价值. 方法 分析52例经活检或手术病理确诊为膀胱癌患者晨起第一、二次新鲜中段尿脱落细胞学检查结果,以连续3 d标本结果和单次标本结果为研究对象,按总体、病理分级及临床分期分别计算2个时段尿脱落细胞阳性率,并进行统计学分析. 结果 52例患者晨起第一、二次新鲜中段尿脱落细胞学检查阳性率分别为78.8%(41/52)和80.8%(42/52);156个标本晨起第一、二次尿阳性率分别为56.4%(88/156)和60.9%(95/156).33例G1～Gz患者晨起第一、二次尿阳性率分别为69.7%(23/33)和72.7%(24/33);99个标本晨起第一、二次尿阳性率分别为44.4%(44/99)和4 8.5%(48/99).42例非肌层浸润性膀胱癌患者晨起第一、二次尿阳性率分别为73.8%(31/42)和76.2%(32/42);126个标本晨起第一、二次尿阳性率分别为54.8%(69/126)和57.1%(72/126).晨起第一、二次新鲜中段尿脱落细胞学检查诊断膀胱癌、低分级膀胱癌及非肌层浸润性膀胱癌的阳性率比较差异均无统计学意义(P＞0.05).结论 晨起第一次新鲜中段尿可用为尿脱落细胞学检查诊断膀胱癌的尿液标本,对于低分期、低分级膀胱癌有不亚于晨起第二次新鲜中段尿的诊断价值.     

尿脱落细胞Cox-2mRNA检测在膀胱癌诊断中的价值

目的探讨尿脱落细胞Cox-2基因检测在膀胱癌诊断中的价值.方法采用逆转录聚合酶链反应(RT-PCR)半定量法检测31例膀胱癌患者、42例泌尿系良性疾病患者和8例健康志愿者清晨中、后段尿脱落细胞Cox-2mRNA的表达,并与尿脱落细胞学检查相对照.结果用RT-PCR法检测尿脱落细胞Cox-2 mRNA用于诊断膀胱癌的特异性为72.1%,低于尿脱落细胞学检测(100%)(P ＜0.05),但敏感性为100%,高于尿脱落细胞学检测(64.5%)(P＜0.01).;表达Cox-2 mRNA的部分膀胱良性疾病患者,其强度与G1膀胱癌患者之间的差异无统计学意义(P＞0.05),但与G2、G3膀胱癌患者之间的差异有统计学意义(P＜0.05);膀胱癌患者尿脱落细胞Cox-2mRNA的表达强度随膀胱癌分级的增高而升高(P＜0.05);浸润性膀胱癌患者表达Cox-2的强度高于浅表性膀胱癌患者(P＜0.01).结论采用RT-PCR法检测尿脱落细胞Cox-2mRNA的表达可作为膀胱癌早期诊断、复发监测的一项极其灵敏的方法,并有助于肿瘤分级分期的判断.     

不同标准对荧光原位杂交技术在膀胱癌诊断中应用的影响

目的：探讨不同标准对荧光原位杂交技术（fluorescence in situ hybridization,FISH）诊断膀胱癌的敏感度和特异性的影响。方法：选择20例健康人为正常组,计算FISH检查正常阈值;选择143例血尿患者为病例组．经F1SH检查、尿脱落细胞学检查,比较Urovysion膀胱癌探针斌剂盒标准和正常闯值标准诊断膀胱癌的敏感度和特异性。结果：采用Urovysion标准和正常阈值标准对膀胱癌的诊断敏感度分别为73．1％和100％．均较尿脱落细胞学检查明显增高,三者对膀胱癌诊断的特异性分别为90．0％、86%和100％。Urovysion标准与尿脱落细胞学联合检查时对膀胱癌诊断的敏感度明显升高,差异具有统计学意义（P〈0．01）。结论：FISH检查较尿脱落细胞学检查诊断膀胱癌的敏感度显著提高,相比Urovysion际准,正常闯值更适合FISH诊断膀胱癌的标准。FISH与尿脱落细胞学联合检查能显著提高膀胱癌的诊断敏感度。     

膀胱癌新标志物UPK3A的临床应用研究

目的前瞻性评价人Uroplakin 3A（UPK3A）诊断膀胱癌的作用,探索更好的非侵入性的诊断膀胱癌的方法。方法收集34例健康志愿者、46例良性泌尿外科疾病患者和112例膀胱癌患者的尿液。酶联免疫吸附试验定量检测尿液中UPK3A水平,核基质蛋白22（NMP22）检测试剂盒测定NMP22,同时进行尿脱落细胞学检测。结果膀胱癌患者尿液UPK3A水平明显高于健康志愿者和良性泌尿外科疾病患者,差异有统计学意义（P〈0.01）。UPK3A的受试者工作特征（ROC）曲线显示了一个0.911的良好曲线下面积。以OD0.0685作为临界值可以获得一个较适宜的敏感度（83%）和特异度（84%）的组合。UPK3A、NMP22和尿脱落细胞学诊断膀胱癌的敏感度分别为83%、58%和64%;特异度分别为84%、75%和82%。结论膀胱癌患者尿液UPK3A水平较高,UPK3A可作为诊断膀胱癌的一个敏感的标志物,但还需要大规模的多中心研究进行验证。     

尿脱落细胞增殖细胞核抗原mRNA检测在膀胱癌诊断中的应用价值

目的探讨尿脱落细胞增殖细胞核抗原(PCNA)mRNA检测在膀胱癌诊断中的应用价值。方法收集32例膀胱癌、52例泌尿系统良性疾病患者和10例健康志愿者清晨中、后段尿液,采用RT-PCR法检测尿脱落细胞PCNAmRNA表达,并与尿脱落细胞学检查结果比较。结果PCNAmRNA诊断膀胱癌的特异性为64%,低于尿脱落细胞学检测的88%(P<0.05),敏感性为100%,高于尿脱落细胞学检测的69%(P<0.01)。膀胱良性疾病患者、Ⅰ、Ⅱ、Ⅲ级膀胱癌患者尿脱落细胞PCNAmRNA表达强度分别为0.5128±0.0307、0.5153±0.0402、0.6560±0.0626、0.8657±0.0266。膀胱良性疾病患者与Ⅰ级膀胱癌患者间差异无统计学意义,与Ⅱ、Ⅲ级膀胱癌患者间差异有统计学意义(P<0.05)。膀胱癌患者尿脱落细胞PCNAmRNA表达强度随膀胱癌分级增加而升高(P<0.05)。浸润性膀胱癌患者尿脱落细胞PCNAmRNA表达强度高于浅表性膀胱癌患者(P<0.01),分别为0.8040±0.0807、0.5595±0.0447。结论尿脱落细胞PCNAmRNA检测在膀胱癌早期诊断、常规筛查以及术后复发监测中具有潜在的应用价值。     

联合检测尿液中Survivin和MUC7在膀胱癌诊断中的临床应用

目的探讨检测尿液中Survivin和mucin 7（MUC7）在诊断膀胱癌中的临床价值。 方法对75例膀胱肿瘤患者、38例泌尿系统良性疾病患者及20例健康自愿者在行膀胱镜检前分别留置3份尿液标本,通过检测尿液中Survivin、MUC7和尿脱落细胞学的敏感性和特异性,分析比较3种方法在临床诊断膀胱癌的临床应用价值。 结果Survivin诊断膀胱癌的敏感性和特异性分别是93.3%和98.3%,MUC7诊断膀胱癌的敏感性和特异性分别是80%和100%;尿脱落细胞学诊断膀胱癌的敏感性和特异性分别是66.7%和100%;Survivin联合MUC7的敏感性和特异性分别是98.7%和100%;Survivin联合MUC7、Survivin、MUC7与尿脱落细胞学的敏感性比较差异均有统计学意义（P<0.05）。Survivin联合MUC7、Survivin、MUC7与尿脱落细胞细胞学的准确性分别是99.2%、95.5%、88.7%、81.2.3%,与脱落细胞学组比较,差异有统计学意义（P<0.05）。 结论联合检测两种肿瘤标记物Survivin及MUC7可以提高膀胱癌诊断的敏感性和准确性。     

荧光原位杂交技术在膀胱癌诊断中的临床应用研究

目的探讨利用荧光原位杂交（fluorescence in situ hybridization,FISH）技术提高早期诊断膀胱癌的可能性。方法收集20例健康成人的晨尿用FISH技术检测3号、7号、9号p16位点和17号染色体的变异情况,统计出相应阈值。收集100例膀胱癌疑似患者的晨尿,分别进行尿脱落细胞学检查和FISH技术检测。统计学方法分析FISH技术的敏感性、特异性及与膀胱癌发生、发展的关系。结果100例膀胱癌疑似患者的尿液FISH检测的敏感度为87．50％,特异度为80．00％,总阳性率为79．00％;尿脱落细胞学检查的敏感度为61．54％,特异度为83．33％,总阳性率为49．00％。两种检测方法在敏感度和总阳性率上的差异均具有统计学意义,特异度上差异无统计学意义。FISH检测与膀胱癌的病理分级和临床分期均无相关性。结论FISH技术能成为一种提高中国人群膀胱癌早期诊断及监测膀胱癌预后的新方法。     

尿脱落细胞中存活素和微小染色体支持蛋白5检测在膀胱癌诊断中的价值

目的　探讨尿脱落细胞中存活素和微小染色体支持蛋白5 (MCM5 )检测在膀胱癌诊断中的价值。　方法　膀胱移行细胞癌患者70例,平均年龄61岁,男54例,女16例。G1 25例,G227例,G3 18例。浅表性肿瘤(Tis~T1 ) 47例,浸润性肿瘤(T2 ~T4 ) 23例。泌尿系良性疾病患者40例,平均年龄54岁。健康志愿者10例,平均年龄55岁。采用RT PCR方法检测尿液标本中存活素和MCM5的表达。　结果　存活素、MCM5、联合存活素和MCM5检测诊断膀胱癌的敏感性分别为84. 3% (59 /70)、87. 1% (61 /70)、98. 6% (69 /70)。膀胱癌患者尿脱落细胞中存活素与MCM5阳性率与表达水平均随病理分级及临床分期的升高而增加,但各病理分级和临床分期间存活素表达的差异无统计学意义(P>0. 05),而MCM5表达在病理分级和临床分期间的差异有统计学意义(P<0. 05)。3种方法诊断膀胱癌的敏感性均明显高于尿细胞学检查(48. 6%,P<0. 05);联合存活素和MCM5诊断敏感性明显高于单独检测存活素或MCM5(P<0. 05);存活素与MCM5检测敏感性的差异无统计学意义(P>0. 05)。4种方法诊断膀胱癌的特异性分别为94. 0%、92. 0%、88. 0%、100. 0%,差异无统计学意义(P>0. 05)。　结论　尿液中存活素与MCM5检测是膀胱肿瘤早期诊断和预后评估的敏感、非侵入性方法,二者联合分析可提高     

核基质蛋白22检测与尿脱落细胞学检查在膀胱癌诊断中的价值

目的　探讨尿核基质蛋白 2 2 (NMP 2 2 )检测和尿脱落细胞学检查在膀胱移行细胞癌诊断中的价值。　方法　对 15 5例怀疑膀胱癌者进行尿NMP 2 2与尿细胞学检查 ,其中 95例经组织学证实为膀胱移行细胞癌。比较两者诊断膀胱癌的敏感性和特异性。　结果　尿NMP 2 2的敏感性为6 5 .3%、特异性为 70 .0 % ;尿细胞学的敏感性为 4 3.2 %、特异性为 83.3%。NMP 2 2在膀胱癌不同分级和分期中的敏感性优于尿细胞学 (P <0 .0 5 )。　结论　尿NMP 2 2检测在早期诊断膀胱癌方面优于尿细胞学检查 ,可以作为膀胱癌的早期检测指标。     

Comparative evaluation of the nuclear matrix protein,fibronectin, urinary bladder cancer antigen and voided urine cytology in the detection of bladder tumors

PURPOSE: We evaluate the diagnostic efficacy of nuclear matrix protein-22 (NMP22, Matritech, Newton, Massachusetts), fibronectin and urinary bladder cancer antigen (UBC, IDL Biotech, Borlange, Sweden) compared with voided urine cytology in the detection of bladder cancer. MATERIALS AND METHODS: A total of 168 patients provided a single voided urine sample for NMP22, fibronectin an ideal monoclonal for urinary bladder cancer and cytology before cystoscopy. Cystoscopy was done for all patients as the reference standard for identification of bladder cancer. Biopsy of any suspicious lesion was performed for histopathological examination. Of the 168 cases 100 were histologically diagnosed as bladder cancer, whereas the remaining 68 had benign urological disorders. A group of 47 healthy volunteers were also enrolled in this study. Voided urine was evaluated by NMP22, fibronectin and UBC, and their values were expressed relative to mg. creatinine. RESULTS: The optimal threshold values for NMP22, fibronectin and UBC were calculated by receiver operator characteristics curves as 27 units per mg. creatinine, 198 mg./mg. creatinine and 13 ng./mg. creatinine, respectively. The levels and positive rates of the 3 parameters were significantly higher in the malignant group compared to either the benign group or normal controls. Of the entire group NMP22, fibronectin and UBC were positive in 93.2%, 91% and 68.2%, respectively in bladder cancer cases with positive cytology. Moreover, these positive rates were significantly higher in bilharzial bladder cancer cases (58.8%, 67.5%, 58.8%, respectively) compared to nonbilharzial cases (35.6%, 36.3%, 31.1%). Overall sensitivity and specificity were 85% and 91.3% for NMP22, 83% and 82.6% for fibronectin, 67% and 80.8% for UBC and 44% and 100% for voided urine cytology. Combined sensitivity of voided urine cytology with the 3 biomarkers together was higher than either combined sensitivity of voided urine cytology with 1 of the biomarkers or than that of the biomarker alone. CONCLUSIONS: Our data indicate that NMP22 and fibronectin had superior sensitivities compared to UBC and voided urine cytology, while NMP22 and voided urine cytology had the highest specificities. The combined use of markers increased the sensitivity of cytology from 44% to 95.3%. The higher sensitivities of markers in bilharzial than nonbilharzial bladder cancer highlight their clinical use in screening patients with urinary bilharziasis.     

Qualitative and quantitative detection of urinary human complement factor H-related protein (BTA stat and BTA TRAK) and fragments of cytokeratins 8, 18 (UBC rapid and UBC IRMA) as markers for transitional cell carcinoma of the bladder

OBJECTIVE: To evaluate the role of BTA stat, BTA TRAK, UBC Rapid, UBC IRMA and voided urinary cytology in the detection of bladder transitional cell carcinoma (TCC). METHODS: The study included 78 patients with TCC of the bladder (group A), 62 patients with a history of bladder TCC without tumor recurrence at the time of examination (B, control group), 20 patients with other malignancy of the urinary tract (C), 38 patients with non-malignant urinary tract diseases (D), 10 patients with urinary tract infection (E) and 10 healthy volunteers (F). Except in group F, voided urine was collected before cystoscopy or cystectomy. RESULTS: The specificity and sensitivity in bladder cancer detection were 87.1 and 74.4%, respectively with BTA stat, 79.3 and 48.7%, respectively with UBC Rapid, 100 and 33.3%, respectively with cytology, 72.6 and 75.6%, respectively with BTA TRAK, 64.5 and 70.5%, respectively with UBC IRMA. CONCLUSIONS: The BTA stat and BTATRAK tests are superior to UBC Rapid, UBC IRMA and urinary cytology in detection of bladder TCC. In daily practice however cytology remains the best adjunct to cystoscopy because of its high sensitivity in Tis and 100% specificity. Cystoscopy cannot be replaced by any of evaluated methods.     

尿脱落细胞CK20检测在膀胱癌诊断中的价值

目的:检测膀胱癌患者尿脱落细胞细胞角蛋白20(CK20)表达情况并探讨其在膀胱癌诊断中的价值。方法:应用RT-PCR方法分别检测35例膀胱癌患者、8例泌尿生殖系良性疾病患者及4例健康自愿者尿脱落细胞CK20表达情况,并与尿脱落细胞学检查结果进行比较。结果:35例膀胱癌患者中有26例的自排尿标本中可检测出CK20(敏感度为74.29％)。尿脱落细胞学检测阳性例数则为12例(敏感度为34.29％)。前者与后者比较差异有显著性意义(P<0.05)。8例泌尿生殖系良性疾病患者及4例健康自愿者的自排尿标本中无一例可检测出CK20(特异性为100％)。不同分化程度及不同临床病理分期膀胱癌患者之间尿脱落细胞(2K20阳性表达率的差异有显著性意义(P<0.05)。结论:尿脱落细胞CK20检测的敏感性及特异性均高,有望成为膀胱癌诊断和术后复发监测的一种有效手段。     

荧光原位杂交技术在膀胱尿路上皮癌诊断中的临床应用

目的 探讨荧光原位杂交(FISH)技术运用于膀胱尿路上皮癌的诊断价值.方法 收集20例健康志愿者的新鲜晨尿,运用荧光标记的3号、7号、17号染色体着丝粒探针及9号染色体p16位点探针,对尿液标本中的脱落细胞染色体进行FISH技术检测,建立正常人群的阈值.收集158例怀疑为膀胱尿路上皮癌患者的新鲜晨尿,在行膀胱镜检查前,同期进行FISH技术与尿脱落细胞学检测,运用统计学方法,比较FISH技术与尿脱落细胞学检测的敏感性与特异性.结果 FISH与尿脱落细胞学的敏感性分别为84.8%和43.8%,FISH敏感性高于尿脱落细胞(P<0.05),FISH与尿脱落细胞学特异性分别为89.1%和87.0%,两者无统计学差异(P>0.05),在不同的肿瘤病理分级中,FISH的敏感性都高于尿脱落细胞,并且FISH敏感性随肿瘤分级逐级升高(P<0.05).结论 FISH技术具有较高的敏感性和特异性,可以作为国人膀胱尿路上皮癌筛查、诊断的新方法.     

Urine survivin as a diagnostic biomarker for bladder cancer: a systematic review

What's known on the subject? and What does the study add? Although many tests for identifying patients with new or recurrent bladder cancer have been used, a reliable method has yet to be established. Recently, increasing attention has focused on the role of survivin in bladder cancer detection. Because urine survivin tests have better sensitivity than cytology, urine survivin could potentially replace routine cytology and might be used as an adjunct method for cystoscopy. However, the clinical utility of urine survivin as a bladder tumour marker identified in the present study remains to be elucidated. To determine the clinical utility of urine survivin as a bladder tumour marker we systematically reviewed the available evidence. A comprehensive literature review was performed, from August 1997 to March 2011, using three search engines in English including PubMed, Cochrane Library, and SCOPUS. Two reviewers independently evaluated both trial eligibility and methodological quality and data extraction. We included studies that evaluated urine survivin, used cystoscopy and/or histopathology as the reference standard, and allowed the construction of a 2 × 2 contingency table. Bivariate random effect meta‐analyses were used to calculate the summary estimated of sensitivity and specificity and to construct a summary receiver‐operating characteristics curve of urine survivin tests. In all, 14 studies were included in the present review; two studies had two subsets of data. There were 2051 subjects, including 1038 in the case group and 1013 in the control group, and heterogeneity was present among diagnostic studies. The pooled sensitivity and specificity for urine survivin tests were 0.772 (95% confidence interval [CI] 0.745–0.797) and 0.918 (95% CI 0.899–0.934), respectively. The area under the curve of urine survivin tests was 0.9392. When a subgroup analysis with six studies was performed, urine survivin tests had better sensitivity than cytology, but did not match cytology for specificity. The clinical utility of urine survivin as a bladder tumour marker identified in the present study remains to be elucidated.     

Clinical utility of a multiprobe FISH assay in voided urine specimens for the detection of bladder cancer and its recurrences,compared with urinary cytology

OBJECTIVES: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.