新型尿脱落细胞学检查方法诊断尿路上皮癌的临床研究  

Study on the diagnostic value of a novel urine cytology test for urothelial carcinoma

作　　者：陈宇豪 徐锋 刘娓 刘喆 王祖恒 黄杰 程文 CHEN Yuhao;XU feng;LIU Wei;LIU Zhe;WANG Zuheng;HUANG Jie;CHENG Wen(Department of Urology,Jinling Hospital,Medicine School of Nanjing University,Nanjing 210002,China)

机构地区：[1]南京大学医学院附属金陵医院(东部战区总医院),210002

出　　处：《现代泌尿生殖肿瘤杂志》2022年第4期223-228,235,共7页Journal of Contemporary Urologic and Reproductive Oncology

摘　　要：目的以新柏氏液基细胞学检查(TCT)方法为对照,评价新型尿脱落细胞学检查方法用于诊断尿路上皮癌的应用价值。方法收集南京大学医学院附属金陵医院(东部战区总医院)2018年6月至2019年10月期间收治的91例因影像学结果或无痛性肉眼血尿怀疑有尿路上皮癌患者的临床资料,所有患者均采用新型尿脱落细胞学检查方法和TCT法。新型尿脱落细胞学检查方法是将每位患者晨起第1次小便至送检前全部尿液经静置、离心、酸洗、水洗等预处理后用10%甲醛溶液封存。制片前对有明显组织或细胞团块的样本采用滤纸过滤,对细胞量较少、细胞难以聚集的样本采用琼脂凝胶先行包埋,然后脱水、透明、浸蜡包埋,切片后染色并阅片。TCT法则是收集第2次晨尿中段尿标本,经静置、离心、清洗液清洗后加入新柏氏保存液,静置后使用新柏氏T5000全自动液基薄层细胞制片仪制片,染色后封片、阅片。先比较新型尿脱落细胞学检查方法和TCT法在样本总体中诊断尿路上皮癌的敏感性、特异性、准确性的差异,再比较两种方法在不同类型、不同性别、首发和复发患者中的诊断敏感性差异,然后比较新型尿脱落细胞学检查方法对于不同类型、不同性别、首发和复发患者的诊断敏感性差异,最后比较两种方法的制片质量和费用。结果新型尿脱落细胞学检查方法和TCT法检测尿路上皮癌的敏感性分别为64.9%(48/74)和45.9%(34/74),特异性分别为88.2%(15/17)和82.4%(14/17),准确性分别为69.2%(63/91)和52.7%(48/91),结果表明采用新型尿脱落细胞学检查方法检测尿路上皮癌的敏感性和准确性更高(P<0.05),在特异性方面两种方法差异无统计学意义;新型尿脱落细胞学检查方法在高级别尿路上皮癌和肌层浸润性尿路上皮癌中检测的敏感性分别为77.8%(42/54)和93.2%(41/44),较TCT法的30.0%(6/20)和65.9%(29/44)更高(P<0.05);其在不同�Objective To evaluate the application value of the novel urine cytology test for the diagnosis of urothelial carcinoma by using the TCT method as a control.Methods The study included 91 patients suspected of having urothelial carcinoma due to imaging findings or painless gross hematuria admitted to our hospital from June 2018 to October 2019.In the novel urine cytology test group,all the urine of each patient from the first urination in the morning to before the test was sealed with 10%formaldehyde solution after pretreatment such as standing,centrifugation,acid washing,and water washing.Before preparation,the samples with obvious tissue or cell clumps were filtered with filter paper,and the samples with less cells and difficult to aggregate cells were embedded in agar gel first,and then dehydrated,transparent embedded in wax,sliced,stained and read.In TCT group,the midstream urine samples of the second morning urine were collected,and after standing,centrifugation,and washing with washing liquid,Thinprep preservation solution was added.After standing,use Thinprep T5000 automatic liquid-based thin-layer cell preparation machine to prepare,HE staining,sealing and reading.We compared the sensitivity,specificity and accuracy of the novel urine cytology test and TCT in the diagnosis of urothelial carcinoma in the sample population,and then compared the difference in the diagnostic sensitivity of the two methods in different types,different genders,first-episode and relapsed patients.Furthermore,the diagnostic sensitivity of the novel urine cytology test to different types of urothelial carcinoma was compared,and the production quality and cost of the two methods were compared.Results The sensitivity of the novel urine cytology test and TCT were 64.9%(48/74)and 45.9%(34/74),respectively,and the specificity were 88.2%(15/17)and 82.4%(14/17),respectively.The correct rates were 69.2%(63/91)and 52.7%(48/91),respectively.The sensitivity of the new method was higher(P<0.05)and the correct rate was higher(P<0.05).There was n

关 键 词：新型尿脱落细胞学检查 新柏氏液基细胞学检查 尿路上皮癌 

分 类 号：R737.1[医药卫生—肿瘤]