荧光原位杂交检测尿脱落细胞染色体异常诊断膀胱肿瘤的研究.docVIP

荧光原位杂交检测尿脱落细胞染色体异常诊断膀胱肿瘤的研究 王 鹏，靳风烁，叶 锦，吴 刚，李彦锋，张 尧，梁 平 （第三军医大学大坪医院野战外科研究所泌尿外科，重庆 400042） 摘 要：目的 本研究旨在探讨通过荧光原位杂交（Fluorescence in situ hybridization，FISH)3、7、17 号染色体着丝粒探针和9p21区带探针对140例观察者尿液脱落细胞核行荧光原位杂交，并同时行经腹部超声和尿脱落细胞学检查，以膀胱镜病理检查确诊，比较分析各种方法的敏感性和特异性。结果 ⑴ 肿瘤组80例膀胱尿路上皮癌全部经病理检查确诊，其中68例FISH结果阳性，26例尿脱落细胞学阳性，71例经腹部超声诊断为膀胱癌。⑵ 非肿瘤对照组30例，其中29例FISH结果阴性，1例假阳性；尿脱落细胞学检查全部阴性；经腹超声检查23例阴性，7例假阳性。FISH、尿脱落细胞学、经腹部超声的灵敏度分别为85.00%、32.50%、88.75%，特异度分别为96.67%、100.00%、76.67%。结论 使用FISH技术检测尿脱落细胞3、7、9、17号染色体数目畸变，具有敏感度高、特异性强的优点，并具无创性，对国人膀胱尿路上皮癌的诊断具有重要的临床应用价值。 关键词：膀胱肿瘤；原位杂交；诊断 中图法分类号：R737.14 文献标识码：A The study on urine exfoliated cell chromosome aberration detected by fluorescence in situ hybridization of the bladder Wang Peng, Jin Feng-shuo Ye Jin, Wu Gang, Li Yan-feng, Zhang Yao, Liang Ping (Department of Urology, The Third Affiliated Hospital of Third Military Medicial University, Chongqing 400042, China) Abstract：Objective The aim of this study was to evaluate the possibility and validity of detecting numerical aberration of chromosome 3,7,9,17 by fluorescence in situ hybridization (FISH) in detecting urothelial carcinoma of bladder in Chinese. Mehtods 140 volunteers were recruited as subjects. Exfoliated cells from fresh urinary specimen was collected and the cell was examined by FISH using centromeric probes of chromosome 3,7,17 and region probe of 9p21. Cytology and transabdominal ultrasonography (US) was applied at the same time and all of the patients were definitely diagnosed by cystoscopy and biopsy. The sensitivity and specificity of each method in the diagnosis of bladder cancer were determined by comparative analysis. Results ⑴ Tumor group: The subjects include 80 patients with urothelial carcinoma definitely diagnosed by pathology. 68 patients show positive by FISH, 28 are positive by urine cytology, and 71 are positive by US. ⑵In non-tumor control group of 30 cases, 29 show negative and 1 false-positive by FISH,30 negative by urine