荧光原位杂交在尿路上皮癌诊断中的临床应用价值  

The clinical value of fluorescence in situ hybridization in the diagnosis of urothelial carcinoma

作　　者：吴文起[1] 赵振华[1] 梁叶萍[1] 欧莉莉[1] 李舒珏[1] 曾国华[1] 

机构地区：[1]广州医学院第一附属医院微创外科中心泌尿外科广东省泌尿外科重点实验室,510230

出　　处：《中国医师进修杂志》2012年第29期3-5,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨荧光原位杂交（FISH）在诊断尿路上皮癌中的临床价值。方法对27例疑似尿路上皮癌患者尿液中的脱落细胞进行FISH检查，并同期进行经内窥镜活组织病理学检查。将FISH检查结果和经内窥镜活组织病理学检查结果进行比较，分析FISH检查尿路上皮癌的敏感度、特异度，并综合检查费用评价FISH检查用于诊断尿路上皮癌的临床价值。结果27例患者中，经内窥镜活组织病理学检查结果阳性11例，FISH检查结果阳性9例，其中7例包括在经内窥镜活组织病理学检查结果阳性患者中，FISH检查敏感度为63．6％（7／11），特异度为87．5％（14／16），而FISH检查费用（3100元）为经内窥镜活组织病理学检查费用（1000元）的3．1倍。结论与经内窥镜活组织病理学检查结果相比，FISH检查诊断尿路上皮癌的敏感度及特异度均较低，且检查成本高，故其在临床中的应用价值尚需进一步证实。Objective To investigate the clinical value of fluorescence in situ hybridization （FISH） in the diagnosis of urothelial carcinoma. Methods From September 2010 to October 2011, morning voiding urine of 27 patients with suspected urothelial carcinoma was collected for FISH examination. The results of FISH examination were compared with the results of pathological examination by endoscopic biopsy. Both sensitivity and specificity were compared respectively, and the cost of each kind of examination was also considered. Results Of 27 cases, pathological examination by endoscopic biopsy revealed 11 cases of urothehal carcinoma, FISH examination showed 9 cases of urothelial carcinoma,but only 7 cases in these 11 cases. The overall sensitivity of FISH examination was 63.6% （7/11 ）, the specificity was 87.5%（14/16）. The cost per case of FISH examination （3100 yuan） was 3.1 times of pathological examination by endoscopic biopsy（ 1000 yuan）. Conclusions It showed that there is no advantage ofFISH examination for diagnosis of urothelial carcinoma considering both the sensitivity and specificity, and the cost is also higher than that of pathological examination by endoscopic biopsy. It should be evaluated further when FISH examination is widely used in clinic.

关 键 词：原位杂交 荧光 泌尿系肿瘤 内窥镜 活组织检查 

分 类 号：R737.1[医药卫生—肿瘤]