FISH技术对低级别尿路上皮癌复发、进展风险亚分层的研究  

Utility of Fluorescence in situ hybridization(FISH) to sub-classify and determine low-grade urothelial carcinoma recurrence and progression

作　　者：陈毅[1] 杨伟娇[2] 向雪宝 张天禹[1] 高漓[1] 石海林[1] 周祥福[2] 黄洁夫[1] 

机构地区：[1]桂林医学院附属医院泌尿外科,541000 [2]中山大学附属三院泌尿外科,广州510630

出　　处：《中华腔镜泌尿外科杂志（电子版）》2016年第5期55-58,共4页Chinese Journal of Endourology(Electronic Edition)

基　　金：广西自然科学基金(2013GXNSFAAO19223);广西卫生厅课题(Z2013472);广西研究生教育创新计划项目:YCSZ2015215

摘　　要：目的通过分析荧光原位杂交技术（FISH）检测的低级别尿路上皮癌（uc）的尿液标本结果以及相关临床资料，探讨FISH技术对低级别UC复发、进展风险进行亚分层的可能。方法从2009年1月到2015年1月间，收集桂林医学院附属医院及中山大学附属第三医院确诊为UC的患者107例，应用FISH技术检测患者尿液标本中的3、7、17、9p16号染色体，随访至2016年1月，平均47个月（6～80个月），结合临床资料，通过x^2检验分析染色体突变与低级别尿路上皮癌术后复发、进展的相关性。结果尿液中FISH检查出现CSP7／CSP17阳性并CSP3／GLPp16阳性者20例，CSP3／GLPp16阴性者28例，其中前者10例复发，8例进展；后者13例复发，10例进展；CSP7／CSP17阴性并CSP3／GLPp16阳性者36例，CSP3／GLPp16阴性者23例，其中前者8例复发，4例进展；后者5例复发，1例进展。通过x^2检验对CSP7／CSP17阳性者与CSP7／CSP17阴性者比较分析，CSP7／CSP17阳性和CSP3／GLPp16阳性比较分析，前者更易复发和进展（P〈O．05）；CSP3／GLPp16阳性与CSP3／GLPp16阴性者、FISH全阴性者比较，CSP7／CSP17阳性中CSP3／GLPp16阳性者和CSP3／GLPp16阴性者比较，复发、进展皆无统计学意义（P〉0．05）。结论本研究证实FISH检查出尿液标本中的3、7、17、9p16染色体变异能协助低级别UC的风险分层，CSP7／CSP17阳性者易复发、进展，如果同时CSP3／GLPp16阳性则复发较早，CSP7／CSP17阴性者术后不易复发、进展。Objective Using fluorescence in situ hybridization （FISH） to examine the urine specimens of low-grade urothelial carcinoma （UC） patients to determine the possibility of sub-classifying the recurrence and progression of UC. Methods Urine of 107 patients diagnosed with low-grade UC from January 2009 to January 2015 the Affiliated Hospital of Guilin Medical University and the Third Affiliated Hospital of Sun Yat-sen University were used a UroVysion kit to detect the copy number aberration of chromosomes 3, 7, 17, and 9P16. An average 47-month （6-80 months） follow-up comP1eted in January 2016 combined with the clinical follow-up data were evaluated with chi-square （x^2） to analyze the relative copy number aberration of chromosomes in relation to tumor recurrence and progression. Results Ten cases recurred in 20 CSP7/CSP17-positive patients, 8 of which were defmed as high grade. Thirteen cases recurred in 28 CSP7/CSP17-positive and CSP3/GLPP16-negative patients, 10 of which were defined as high grade. Eight cases recurred in 36 CSP7/CSP17-negative and CSP3/GLPP16-positive patients, 4 of which were defined as high grade. Five recurrences and 1 case of progression were found among 23 negative patients. The x^2 analysis showed significant results for recurrence and progression （P〈0.05） when comparing CSP7/CSP17 positivity to CSP7/CSP17 negativity and comparing only CSP7/CSP17-positive to only CSP3/GLPP16-positive cases. No statistically significant differences were found for recurrence or progression （P〉0.05） when comparing CSP3/GLPP16-positive with CSP3/GLPP16-negative or all-negative patients. And comparing CSP3/GLPP16-positive with CSP3/GLPP16-negative patients within the CSP7/CSP17 group. Conclusion Our follow-up data appear to subdivide low-grade UC patients into low-and high-risk groups for recurrence and progression based on chromosomal changes observed by FISH. CSP7/CSP17-positive status defines the high-risk group, and CSP3/GLPP16 positivity and FISH negativity define the low-risk gro

关 键 词：低分级 尿路上皮癌 荧光原位杂交 进展 复发 

分 类 号：R737.1[医药卫生—肿瘤]