【摘要】 目的比较双色荧光原位杂交技术与尿脱落细胞学技术在膀胱尿路上皮癌检测中的作用。方法采用3、7、17号染色体着丝粒及9p21区带探针对78例膀胱移行细胞癌患者尿液、30例正常对照尿液中的脱落细胞核进行荧光原位杂交(FISH)研究,并同时对所有标本做尿脱落细胞学检查。结果细胞学检查对于Ta期、T1期及T2～T4期肿瘤的敏感度分别为35.5%(11/31)、54.1%(13/24)及69.6%(16/23),总敏感性为51.3%。FISH对于TTa期、T1期及T2～T4期肿瘤的敏感性分别为64.5%(20/31)、87.5%(21/24)及95.7%(22/23),总敏感性为80.8%。对于T1期肿瘤(P=0.047)、T2～T4期肿瘤(P=0.023)、GⅡ(P=0.004)、GⅢ(P=0.002)以及所有肿瘤总体(P=0.001),FISH的敏感性均显著高于细胞学检查。细胞学检查和FISH的特异性分别为96.6%和93.3%(P=0.612)。结论 FISH用于检测膀胱癌的敏感性高于细胞学检查,而特异性无显著性差异。FISH技术能明显改进膀胱癌的诊断,对于膀胱癌的筛查有重要意义。更多还原

【Abstract】 [Objective]To evaluated the performance of a dual-color FISH (fluorescence in situ hybridization) assay for urothelial carcinoma (UC) of the bladder, in comparison to urinary cytology[.Methods]Fluorescence in situ hybridization (FISH) was performed using centromeric probes of chromosome 7, 9, 17 and 9p21 region to examine chromosome aberration of exfoliated cells in 78 urine samples from patients with urothelial carcinoma (UC) of the bladder, 30 urine samples from healthy control. All of the samples were analyzed by urinary cytology at the same time[.Results]The sensitivity of urine cytology for Ta, T1 and T2-T4 tumors was 35.5% (11/31), 54.1 %(13/24) and 69.6% (16/ 23), respectively, for an overall sensitivity of 51.6%. The sensitivity of FISH for Ta, T1 and T2-T4 tumors was 64.5% (20/31), 87.5% (21/24) and 95.7% (22/23), respectively, for an overall sensitivity of 80.8%. FISH was significantly more sensitive than cytology for T1 (P =0.047), T2-T4 (P =0.0235), grade Ⅱ (P =0.004), grade Ⅲ(P =0. 002) and all tumors (P =0.001). The specificity of cytology and FISH was 98% and 96%, respectively (P =0.612)[.Conclusion] The sensitivity of FISH for the detection urothelial carcinoma (UC) of the bladder is superior to that of cytology, and the specificity of FISH and cytology for urinary bladder cancer are not significantly different. FISH can improve significantly the diagnosis of urinary bladder cancer and will be significant for screening of urinary bladder cancer.更多还原