Urothelial carcinomas, or transitional cell carcinomas, represent the vast majority of human bladder cancers. Early molecular events associated with superficial bladder cancers include losses on chromosome 9p/9q and mutations in the p53 and retinoblastoma tumor suppressor genes. 1,2 The genomic alterations associated with disease progression, defined as the evolution of superficial bladder tumors to higher pathological stages, are complex and poorly understood. Conventional metaphase-based comparative genomic hybridization (CGH) has been used by several groups of investigators to study copy number imbalances in bladder cancer specimens of all stages and grades. These studies have illustrated the genomic complexity of bladder cancer and have identified recurrent regions of DNA copy number increase or high level amplification on several chromosomes including; 1q, 5p, 6p, 8q, 10p, 12q, 17q, and 20q. 3-9 These genomic regions are thought to contain oncogenes that may be important in tumor progression.Metaphase CGH studies have demonstrated copy number gains or high level amplifications at 6p22 in 7 to 55% of urothelial carcinomas, involving primarily the bladder, 3-9 but also those arising in the renal pelvis. 10 In addition, Bruch et al 11 reported 6p22 gains in 6 of 8 bladder cancer cell lines. Recently, Veltman et al 12 confirmed the metaphase CGH findings using array-based CGH to show copy number gains at 6p22 in 11 of a series of 41 bladder tumors. The changes at 6p22 in bladder cancer have been associated with high tumor cell proliferative activity, 9 tumors of high histological grade that are predominantly invasive, 3-9 and patients with distant metastases at initial presentation. 8 Based on these findings,