荧光原位杂交法和全自动图像细胞仪在膀胱尿路上皮癌诊断中的应用  

The application of fluorescence in situ hybridization and automated image cytometry in the diagnosis of urothelial carcinoma of bladder

作　　者：顾沈阳[1] 雍永松[1] 王业华[1] 杜拥军[1] 

机构地区：[1]江苏省扬州大学附属苏北人民医院泌尿外科,225001

出　　处：《中华外科杂志》2010年第12期933-936,共4页Chinese Journal of Surgery

基　　金：江苏省卫生厅基金资助项目（H200769）

摘　　要：目的 探讨荧光原位杂交法（FISH）和全自动图像细胞仪（ICM）在膀胱尿路上皮癌诊断中的应用.方法 在2008年8月至2009年3月共选取60例患者,包括20例非尿路上皮癌和40例膀胱尿路上皮癌的患者,取患者的尿液作常规尿细胞学检查、FISH和ICM检测.结果 FISH的敏感性显著高于ICM的敏感性（82.5%比62.5%,P＜0.05）和常规尿细胞学的敏感性（82.5%比25.0%,P＜0.05）,同时ICM敏感性也高于常规尿细胞学的敏感性（62.5%比25.0%,P＜0.05）;FISH、ICM和常规尿细胞学检查的特异性都为100%,三者在特异性方面差异无统计学意义（P＞0.05）.FISH、ICM和常规尿脱落细胞学检测的敏感性与病理分期无相关性（P＞0.05）,但与分级有相关性（P＜0.05）.结论 FISH和ICM在膀胱尿路上皮癌诊断中,其特异性和常规尿细胞学检查一致,但敏感性显著高于常规尿细胞学检查;同时FISH在膀胱尿路上皮癌诊断中的敏感性高于ICM,所以FISH技术更有望成为膀胱尿路上皮癌无创性的诊断和检测手段.Objective To discuss the application of automated DNA image cytometry（ICM） and fluorescence in sitn hybridization （FISH） in the diagnosis of urothelial carcinoma of bladder. Methods From August 2008 to March 2009,60 volunteers with informed consent were divided into two groups,40 patients proven as urothehal carcinoma of bladder by pathology and 20 healthy individuals as control.Urine was collected and tested by cytology, ICM and FISH. Results Overall sensitivity of FISH was significantly higher in detection of malignancy than that of ICM（82. 5% vs 62. 5%, P 〈0.05） and that of urine cytology （ 82. 5% vs 25.0%, P 〈 0. 05 ）, while ICM was more sensitive to diagnose urothelial carcinoma of bladder than urine cytology（62. 5% vs 25.0%, P 〈 0. 05 ）. Specificities of urine cytology,ICM and FISH were 100% in diagnosis of urothelial carcinoma of bladder （P 〉 0. 05 ）. Sensitivities of urine cytology, ICM and FISH have no correlation with pathological stage （P 〉 0.05 ）, but have significantcorrelation with grade（ P 〈 0. 05 ）. Conclusions ICM and FISH have the same specificity as urine cytology in diagnosis of urothelial carcinoma of bladder, but they have significantly higher sensitivity than urine cytology. FISH has the highest sensitivity among three diagnostic methods. Therefore, FISH may become a newly non-invasive technique for the diagnosis and surveillance of urothelial carcinoma of bladder.

关 键 词：膀胱肿瘤 图像细胞测定 原位杂交 荧光 尿细胞学检查 

分 类 号：R737.14[医药卫生—肿瘤]