荧光原位杂交技术在膀胱癌诊断中的应用  

Diagnosis of Bladder Cancer Using Fluorescence in Situ Hybridization Technique

作　　者：陈文轩[1] 汤坤龙[1] 郭洪波[1] 彭杰[1] 林毅[1] 

机构地区：[1]天津医科大学总医院泌尿外科,300052

出　　处：《中国综合临床》2011年第9期900-903,共4页Clinical Medicine of China

基　　金：卫生部医药卫生科技发展研究中心课题（WKJ2007-3-001）

摘　　要：目的探讨荧光原位杂交（FISH）检测尿脱落细胞染色体畸变在膀胱癌诊断中的临床应用价值。方法采用3、7及17号染色体着丝粒特异性探针及9号染色体p16位点特异性探针对20名健康人（正常组）新鲜晨尿进行FISH检测，建立阅值。留取75例膀胱癌（膀胱癌组）患者和25例非膀胱癌对照（非膀胱癌对照组）患者晨尿分别进行FISH检测及尿脱落细胞学检查。以至少两种探针检测结果超过阈值或一种探针检测结果存在至少两种异常为诊断阳性。结果四种探针单一应用诊断膀胱癌的灵敏度分别为73．3％（55／75）、76．0％（57／75）、62．7％（47／75）和62．7％（47／75），联合应用的灵敏度为85．3％（64／75），特异度为96．0％（24／25）。尿脱落细胞学检查的灵敏度和特异度则分别为9．3％（7／75）和100．O％（25／25）。FISH检测诊断膀胱癌的灵敏度明显高于尿脱落细胞学检查（85．3％与9．3％，X2=57．00，P〈0．001）。FISH检测诊断膀胱癌的灵敏度与膀胱癌病理分级（低级别为84．2％，高级别为86．5％，x2=0．08，P〉0．05）及临床分期（Ta—T1为82．9％，T2～T4为87．5％，X2=0．32，P〉0．05）均无关。结论荧光原位杂交技术检测尿脱落细胞染色体畸变诊断膀胱癌灵敏度高、特异性强、无创伤性，可作为膀胱癌早期诊断的一项重要方法，并可在预测肿瘤生物学行为及预后方面具有重要的临床意义。Objective To evaluate the value of using fluorescence in situ hybridization （FISH） technique for the detection of chromosome aberration of urine exfoliated cells for the diagnosis of bladder tumor. Methods FISH technique were used to detect the abnormalities of chromosome 3,7,17 and 9p16 site from 20 normal people, and to establish the threshold. The morning＇s first urinations were available from 75 patients with bladder cancer and 25 patients without urothelial tumor, then were detected using FISH technique and urine cytology respectively. The sample was considered positive if two or more probes results higher than the criteria,or one probe has two or more abnormal results. Results The sensitivity of single using were 73.3% （55/75）,76.0% （57/75）,62.7% （47/75） and 62.7% （47/75） for the 4 probes（3,7,17 and 9p16） respectively. The sensitivity of combined detection was 85.3% （64/75）and specificity was 96. 0% （24/25） ~ The sensitivity and specificity of urine cytology examination was 9. 3% （7/75） and 100% （25/25）. The sensitivity of FISH examination was significantly higher than that of urine cytology examination （85.3% vs 9. 3% ,X2 = 57.00, P 〈 O. 001 ） . Sensitivity of FISH examination was not correlated with cancer pathologic grading（ low vs high ： 84. 2% vs 86. 5%, X2 = 0. 08, P 〉 0. 05 ） and clinical stage （ ta - tl ： 82.9%, t2 - t4 ： 87.5%,x2=0. 32,P〉0. 05）.Condusion FISH technique is a non-invasive and effective methed for the early diagnosis of bladder tumor and is more sensitive than urine cytology. Furthermore, FISH technique can be used to predict the tumor＇s biological behavivor and prognosis.

关 键 词：荧光原位杂交 膀胱癌 尿脱落细胞学 

分 类 号：R737.14[医药卫生—肿瘤]