Comparing the clinical accuracy of urine exfoliated cell examination and fluorescence in situ hybridization in the diagnosis of upper urinary tract urothelial carcinoma

BACKGROUND: To compare the effectiveness and clinical accuracy of fluorescence in situ hybridization (FISH) and urine exfoliated cytology in the evaluation of upper urinary tract urothelial cell carcinoma (UTUC). METHODS: 60 patients with suspected UUT-UC admitted to our hospital from May 2021 to May 2023 were selected. All patients underwent FISH and urine exfoliated cytology, and a ureteroscopy pathological biopsy was performed. Using pathological biopsy results as the “gold standard”, we analyzed the compliance rate of FISH and urine exfoliated cytology to evaluate UTUC. RESULTS: Among 60 patients with suspected UTUC, 52 cases were confirmed positive by pathological biopsy, and 8 cases were negative. The positive detection rate of FISH was 90.38%, which was higher than 71.15% of urine exfoliated cytology (P < 0.05). The coincidence rate of urine exfoliated cytology in assessing high-grade UTUC tumors was 76.67%, and the discrepancy rate was 23.33%; the coincidence rate in assessing low-grade tumors was 63.64%, and the discrepancy rate was 36.36%. The coincidence rate of FISH in assessing high-grade UTUC tumors was 93.33%, and the discrepancy rate was 6.67%; the coincidence rate in assessing low-grade tumors was 86.36%, and the discrepancy rate was 13.64%. CONCLUSION: Compared with urine exfoliated cytology, FISH demonstrated higher diagnostic accuracy for the detection of UTUC and greater accuracy in UTUC classification.