摘要
目的分析尿脱落细胞荧光原位杂交(fluorescence insitu hybridization,FISH)检测在膀胱肿瘤诊断中的应用价值。方法对100例临床疑诊膀胱肿瘤患者的尿脱落细胞进行FISH检测、细胞学检查和组织病理学检查,同时设20例正常对照,计算FISH及细胞学诊断的敏感性与特异性。结果 93例膀胱恶性肿瘤的FISH敏感性为93.5%(87/93),高于细胞学敏感性(49.5%,46/93)。其中88例尿路上皮癌的FISH敏感性为94.3%(83/88),细胞学敏感性为52.3%(46/88);5例非尿路上皮恶性肿瘤的FISH敏感性为80.0%(4/5),细胞学均为阴性。FISH对低级别和低分期尿路上皮癌以及膀胱的非尿路上皮来源恶性肿瘤的敏感性均高于细胞学检查(P<0.05)。FISH和细胞学检查对膀胱恶性肿瘤的特异性分别为92.6%(25/27)和96.3%(26/27),差异无统计学意义。而对膀胱尿路上皮癌的特异性分别为81.3%(26/32)和96.9%(31/32),差异有统计学意义(P<0.05)。结论尿脱落细胞FISH检测用于诊断膀胱恶性肿瘤具有高度敏感性和较好的特异性,特别对于细胞学较难检出的低级别尿路上皮癌及非尿路上皮恶性肿瘤具有显著优势。
Objective To investigate the value of fluorescence in situ hybridization（FISH） examination of urine exfoliative cells in the diagnosis of urinary bladder neoplasms.Methods The urine samples were collected from 100 patients with suspected urinary bladder neoplasms and 20 normal control subjects.Both FISH examination and cytology study of urine exfoliative cells were conducted with each sample.The specificity and sensitivity of FISH and cytology were analyzed on the basis of bladder biopsy histology.Results The sensitivity of FISH examination of bladder malignant tumor was 93.5%（87/93）,which was much higher than that of cytology（49.5%,46/93）.Biopsies confirmed 88 cases of urothelial carcinoma among the 100 suspected patients,with 46 high grade tumors and 42 low grade tumors;30 cases of high stage（T2-4） and 58 cases of low stage（Ta-1）.The sensitivity of FISH examination of urothelial carcinoma was 94.3%,which was much higher than that of cytology（52.3%）.FISH examination was significantly more sensitive than cytology for low grade and low stage urothelial carcinoma,as well as for rare non-urothelial malignancies（P〈0.05）.The specificity of FISH and cytology of bladder malignancies was 92.6%（25/27） and 96.3%（26/27）,for urothelial carcinoma was 81.3%（26/32） and 96.9%（31/32）,respectively.Conclusion FISH shows high sensitivity and relatively high specificity for the detection of urinary bladder neoplasms,especially for the diagnosis of low grade urothelial carcinoma and non-urothelial malignancies,which were difficult to be detected by cytology.
出处
《四川大学学报（医学版）》
CAS
CSCD
北大核心
2011年第1期109-113,共5页
Journal of Sichuan University(Medical Sciences)
基金
国家自然科学基金(批准号30871383
30800637)资助
关键词
荧光原位杂交
膀胱肿瘤
尿路上皮癌
脱落细胞
Fluorescence in situ hybridization Urinary bladder neoplasms Urothelial carcinomaExfoliative cell
