荧光原位杂交技术在表浅性膀胱尿路上皮癌中的诊断应用.docVIP

FISH技术在表浅性膀胱尿路上皮癌中的诊断应用 蒋光愉1 潘晓婷1甘丹卉1潘斌2梁蔚波2 暨南大学附属第一医院1病理科，2泌尿外科，广东广州，510630 摘要目的 评价荧光原位杂交(fluorescence in situ hybridization, FISH)技术在表浅性膀胱尿路上皮癌筛查中的临床应用价值，为早期诊断膀胱癌提供新的途径。　方法 建立阈值，通过FISH技术检测9号染色体p16位点、3号染色体、7号染色体及17号染色体变异情况。100例血尿患者留取晨尿，分别进行尿脱落细胞学检查和FISH技术检查，比较两者结果。结果 FISH检测总的敏感性是8.9%(55/64)，尿脱落细胞学检测总的敏感性为.8%(30/64)，P=0.000。pTa～1期的敏感性为.7%(30/35)，尿液脱落细胞学检查检为28.7%(10/35)P= 0.000。结论 FISH技术对表浅性膀胱尿路上皮癌筛查的敏感度优于尿脱落细胞学检查，可以作为临床诊断缺乏依据的早期膀胱癌诊断的一种新方法。 关键词膀胱肿瘤荧光原位杂交技术脱落细胞学 Detection of r from the urine using fluorescence in situ hybridization(FISH) technique JIANG Guang-yu1, PAN Xiao-ting1,GAN Dan hui1, PAN Bin2, LIANG Wei-bo2. 1 Department of Pathology, 2 Department of Urology; The first affiliated hospital, Jinan University, Guangzhou 510630, China. Abstract：Objective To evaluate the clinical significance of fluorescence in situ hybridization(FISH) technique for screening bladder transitional cell carcinoma with hematuria, provide a new method for early diagnosis of bladder cancer.　Methods　Thresholds were established. Morning urine samples collecting from 100 patients with hematuria underwent cytology of the urine and FISH examination, respectively. The sensitivity and specificity of both were analyzed statistically. Results The overall sensitivity of cytology and FISH was 46.8%and 85.9%, and their specificity was 88.9%and 83.3% respectively. The differences between FISH and cytology showed statistical significance in the sensitivity of non-muscle-invasive bladder cancer. Conclusions The FISH test is a reliable method in the diagnosis of bladder cancer in cases with clinical suspicion but negative or doubtful cytology and no diagnostic histology. Key words: Bladder cancer; Fluorescence in situ hybridization; Cytology 膀胱癌是泌尿系常见肿瘤，发病率和死亡率呈逐年上升趋势。目前，临床多数采用膀胱镜检或影像学检查及尿脱落细胞形态学检查作为膀胱尿路上皮癌的早期诊断，提高早期诊断水平对于改善患者生存率及预后有着重要的意义[1]。非肌层浸润性膀胱尿路上皮癌(Tis,Ta,T1)占全部膀胱肿瘤的75~85%，故对其早期诊断和治疗尤为重要[2]。我院于2010年8月~2012年2月采用荧光原位杂交(fluorescence in situ hybridization, FISH)技术对100例血尿患者进行了尿液脱落细胞染色体畸变的检测，评估F