FISH检测尿脱落细胞的临床意义及与肿瘤肌层浸润的关系  

Relationship between FISH test of hematuria exfoliated cells and tumor myometrial invasion in patients with suspected bladder cancer

作　　者：许洁[1,2] 张芬[2] 张明辉[2] 李丽[2] 庄恒国[2] 刘艳辉[2] 赵彤[1] 

机构地区：[1]南方医科大学附属南方医院病理科,广州510515 [2]广东省医学科学院广东省人民医院病理科,广州510010

出　　处：《诊断病理学杂志》2011年第2期98-101,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨荧光原位杂交(FISH)检测在尿脱落细胞染色体畸变中的意义及与膀胱肿瘤病理分期的关系。方法用2组DNA探针CSP3/CSP7分别杂交于3号和7号染色体的着丝粒区域,GLPp16/CSP17分别杂交于9号染色体长臂(9q21)和17号染色体的着丝粒区域,检测36例疑似膀胱肿瘤患者血性尿液中的脱落细胞,与常规尿脱落细胞学检查比较,分析与肿瘤分期的关系。结果 FISH检测总敏感度为73.33%,总特异度为88.46%,总敏感度高于尿细胞学检测(26.70%);肌层浸润敏感度(88.24%)高于非肌层浸润敏感度(53.85%),二者分别高于尿细胞学检测(35.29%,15.38%),差别显著(P<0.05);3、7、9和17号染色体的畸变率分别为88.34%、64.71%、70.59%和88.24%,3号和17号染色体的畸变程度与肿瘤浸润深度呈正相关性(P<0.05)。结论 FISH检测尿脱落细胞诊断膀胱肿瘤优于常规尿脱落细胞学检查,对于有肌层浸润的膀胱肿瘤意义更明显,3号和17号染色体的畸变与肿瘤浸润深度有关。Objective To study the specificity and sensitivity of FISH in detecting chromosome aberration of exfoliated cells in urine,and to evaluate its relationship with pathologic stage of bladder tumor.Methods Two groups of DNA probe were applied in FISH.CSP3 and CSP7 were fit for hybridization of kinetochore domain of chromosomes 3 and 7,respectively,while GLPp16 and CSP17 were fit for hybridization of the long arm of a chromosome 9（9q21）and kinetochore domain of chromosome 17,respectively.Hematuria from 36 cases of putative bladder tumor were submitted to FISH detection,routine cytologic examination and pathological diagnosis were carried out parallelly.Statistic analysis was applied to explore the relationship between the detection results of Fish,cytology and pathologic stage.Results The FISH sensitivity was 73.33%,while specificity was 88.46%,which showed a higher sensitivity than that of cytologic examination（26.70%）.The sensitivity of FISH was higher in muscle-invasive cases（88.24%） than that in non-muscle-invasive cases（53.85%）,and both were higher than that in cytologic examination（15.38%,35.29%）.All of these difference had significantly statistical value（P 0.05）.The aberration ratio in chromosomes 3,7,9,17 was 88.34%,64.71%,70.59% and 88.24%,respectively.The abberant of chromosomes 3 and 17 related to the tumor invasion,and the degree of the aberration positively related to the deepth of tumor invasion（rp = 0.591,P 0.05;rp = 0.523,P 0.05）.Conclusions FISH has higher sensitivity and specificity for the detection of bladder tumors than that of cytologic examination,especially for those with muscle invasion.In addition,chromosomes 3 and 17 abnormalities are correlated to the deepth of invasion.

关 键 词：荧光原位杂交 膀胱肿瘤 染色体畸变 

分 类 号：R737[医药卫生—肿瘤]