荧光原位杂交技术在膀胱癌检测中的临床应用研究  

The use of fluorescence in situ hybridization in the detection of urothelial bladder cancer

作　　者：刘跃新[1] 刘小超[2] 康雯婷[2] 陈山[1] 王伟[1] 闫伟[1] 

机构地区：[1]首都医科大学附属北京同仁医院泌尿外科,100730 [2]首都医科大学附属北京同仁医院中心实验室,100730

出　　处：《北京医学》2013年第1期1-3,共3页Beijing Medical Journal

基　　金：卫生部科研基金课题(WKJ2007-3-001)

摘　　要：目的分析比较荧光原位杂交技术(FISH)与尿液脱落细胞学在膀胱尿路上皮肿瘤检测中灵敏性与特异性的差异。方法 2007年6月至2008年12月,收取20例健康人群的新鲜尿液,应用荧光标记的3号、7号、17号染色体着丝粒探针及p16位点探针,对尿液脱落细胞进行FISH检测,建立正常人群的阈值;留取临床确诊的93例膀胱上皮肿瘤患者的尿液标本,同时进行尿液脱落细胞学检查及FISH检测,对比尿液脱落细胞学检查及FISH检测结果,对FISH、尿液脱落细胞学检查检测膀胱尿路上皮癌的敏感性和特异性进行统计学分析。结果 FISH、尿液脱落细胞学检测膀胱尿路上皮癌总的敏感性分别为90.78%%(69/76)和48.10%%(38/79),P<0.01,特异性分别为82.35%(13/17)、92.85%(13/14),P>0.05。FISH检测膀胱尿路上皮癌的敏感性优于尿液脱落细胞学检查,而两者在特异性方面无统计学意义。结论 FISH技术可以提高膀胱尿路上皮肿瘤的诊断率,优于尿液脱落细胞学检查,是膀胱尿路上皮肿瘤筛查中新的无创性的检查方法。Objective We determine the relative sensitivities and specificities of cytology and fluorescencx in situ hybridization （FISH） for the detection of urothelial bladder cancer in order to evaluate the clinical utility of FISH in the screening of urothelial bladder cancer. Methods From December 2007 to June 2008, the fresh urine voided by 20 healthy volunteers was obtained. A mixture of fluorescxntly labeled Probes were targeted to the chromosomes 3, land 17 and p16. FISH was performed on exfoliated urothelial cells in the urine to get the threshold value of healthy adults. Urine voided by 93 patients with hematuria was collected and examined by cytology and FISH simultaneously before cystoscopy. The McNemar test was used to determine the statistical significance between the yields of different tests. Results The sensitivities of FISH and cytology were 90.78%% （69/76）, 48.10%%（38/79）. The specificities of FISH and cytology were 82.35%（13/17） and 92.85%（13/14）. Conclusion According to this study, the sensitivity of FISH for the detection of urothelial bladder is superior to that of cytology,and the specificities of FISH and cytology for the detection of urothelial bladder cancer are not significantly different.

关 键 词：泌尿系肿瘤 原位杂交 荧光 细胞诊断学 

分 类 号：R737.14[医药卫生—肿瘤]