荧光原位杂交技术在膀胱尿路上皮癌诊断中的应用价值  

Utility of fluorescence in situ hybridization for the diagnosis of bladder urotheliai carcinoma

作　　者：黄建文[1] 安瑞华[1] 李运伟[1] 穆家贵[1] 甘秀国[1] 于雷[1] 原劲杨[1] 

机构地区：[1]哈尔滨医科大学附属第一医院泌尿外科,150001

出　　处：《中华泌尿外科杂志》2012年第12期918-921,共4页Chinese Journal of Urology

摘　　要：目的探讨荧光原位杂交技术（fluorescenceinsituhybridization，FISH）在膀胱尿路上皮癌诊断中的应用价值。方法收集81例膀胱尿路上皮癌患者的新鲜尿液标本，分别行FISH和尿细胞学检测，并行膀胱镜检查；病理诊断泌尿系良性疾病12例合并8例临床诊断泌尿系良性疾病患者的尿液标本作对照。统计学分析FISH和尿细胞学检测诊断的特征值。结果81例均经病理检查确诊膀胱尿路上皮癌。非肌层浸润性膀胱尿路上皮癌34例，肌层浸润性癌14例；低级别42例，高级别24例；由于送检组织不完整，无法准确分期、分级者分别为33例和15例。FISH、尿细胞学和膀胱镜检查诊断膀胱尿路上皮癌的敏感性分别为72．8％（59／81）、27．2％（22／81）和97．5％（79／81），FISH诊断敏感性高于尿细胞学检测（P〈0．05），但低于膀胱镜检查（P〈0．05）；FISH和尿细胞学检测诊断特异性分别为85．O％（17／20）、100．O％（20／20），二者比较差异无统计学意义（P〉0．05）。FISH和尿细胞学检测诊断符合率分别为75．2％（76／101）、41．6％（42／101），二者比较差异有统计学意义（P〈0．05）。结论FISH检测诊断膀胱尿路上皮癌敏感性高、特异性强、无创，临床应用价值高。Objective To evaluate the clinical value of fluorescence in situ hybridization （FISH） method for diagnosis of bladder urothelial carcinoma. Methods Urine samples from 81 patients suspected of having bladder urothelial carcinoma were collected for immediate urine cytology and FISH analysis. All patients underwent eystoscopy for identification of bladder lesions. Urine samples from 8 patients with benign disease of urinary system were also analyzed by means of FISH and cytology. The sensitivity and specificity of FISH were compared with cytology. Results 81 subjects of bladder urothelial carcinoma were verified with pathology, which included 34 non-muscle invasive carcinoma, 14 cases with muscle invasive carcino- ma, 42 eases with high-grade carcinoma, and 24 cases with low-grade carcinoma. Residual cases included 12 verified benign disease of urinary system, and to serve as controls with 8 patients with benign disease of urinary system. The sensitivities of FISH, cytology and eystoseopy were 72.8% , 27.2% and 97.5% . The sensitivity of FISH was superior to cytology, but inferior to cystoscopy. The specificity and diagnostic concordance rate of FISH and cytology were 85.0% , 100.0% and 75.2% , 41.6% , respectively. Conclusion FISH analysis as a non-invasive method has good sensitivity and specificity for diagnosing bladder urothelial carcinoma.

关 键 词：膀胱肿瘤 癌 原位杂交 荧光 尿细胞学 膀胱镜检查 

分 类 号：R737.14[医药卫生—肿瘤]