The incidence of bladder cancer is the highest among urological tumors, especially in China. Nowadays, there are about 360,000 new cases worldwide every year. The incidence of bladder cancer is predominantly male, with men accounting for more than 70%. In China, the incidence of bladder cancer ranks eighth or ninth in the incidence of systemic tumors. In the Western Hemisphere, epithelial bladder cancer accounts for approximately 90-95% of bladder cancers. In the United States alone, 120,000 new cases were generated in 2007, with more than 27,000 related deaths in the same year. The main clinical symptom of bladder cancer is painless hematuria of the naked eye. The gold standard for diagnosis and surveillance of bladder epithelial cancer is cystoscopy and urine cytology testing, but both methods have limitations. Urine cytology has high sensitivity and specificity for highly differentiated tumors (> 75%), but low sensitivity for poorly differentiated tumors (20% – 60%). In addition, cystoscopy is invasive and subjective and has the potential to miss lesions in small or atypical areas. Therefore, there is a growing need for a more sensitive, non-invasive method of detecting epithelial bladder cancer.
UroVysion, developed by Abbott (Des Plaines, IL, USA), uses DNA probes to identify four chromosomal abnormalities associated with bladder cancer. changes of traditional cytology, as well as molecular DNA changes.
UroVysion is based on Abbott’s proprietary fluorescence in situ hybridization (FISH) technology and has been approved by the U.S. Food and Drug Administration. s approval. The method provides a DNA probe that is used to detect aneuploidy of chromosomes 3,7,17 and deletion of the 9p21 gene in malignant bladder epithelial cells in urine. polysomy of chromosomes 3,7,17 is common in highly differentiated tumors and deletion of the 9p21 gene occurs with >60% probability in poorly differentiated tumors. Urovysion? FISH has been reported to have a sensitivity of 73-92% and a specificity of 89-96% in detecting bladder epithelial carcinoma and is used for its diagnosis and surveillance. This DNA-based urine test is capable of detecting genetic alterations in bladder cells and requires only about 50 ml of early morning urine to perform the test, which is almost twice as sensitive as conventional urine cytology tests and can be used as an initial diagnostic test for patients with hematuria. Recent studies have found that due to the high specificity and sensitivity of the test, combined with its reproducibility and high stability, this technique can also be used as a postoperative follow-up for bladder cancer patients, allowing for more subjective and early detection of recurrent cases.