膀胱移行细胞癌各分期分级中荧光原位杂交检测敏感性比较

目的评价荧光原位杂交(FISH)在诊断膀胱移行细胞癌各分期分级中的敏感性。方法应用荧光标记的3、7、17号染色体及p16基因探针检测138例血尿患者尿液中脱落细胞的染色体及基因畸变情况,根据诊断标准计算FISH诊断膀胱移行细胞癌的敏感性。同时留取上述患者尿液送病理科行尿找瘤细胞检查,并比较两种方法对膀胱移行细胞癌的诊断效能。结果 FISH图像中细胞核大且不规则者更易观察到染色体基因异常情况,并可见具有较多染色体改变的细胞呈花斑状的染色图像。FISH和尿细胞学诊断膀胱移行细胞癌的总敏感性为83.9%和36.8%,在各分期分级中敏感性为T1期83.6%和31.3%,T2-4期100%和55.6%,G1级36.3%和9.1%,G2级95.2%和42.9%,G3级100%和50%。FISH诊断膀胱移行细胞癌的总敏感性及在肿瘤各种分期分级中敏感性与尿细胞学结果比较均有统计学差异(P<0.05)。FISH诊断膀胱移行细胞癌敏感性高于尿细胞学。结论 FISH对膀胱移行细胞癌的诊断有较高的敏感度。

Evaluation on significance of fluorescence in situ hybridization (FISH) for detection of bladder cancer

Objective In order to look for a better non - invasive method for diagnosing bladder cancer, the fluorescence in situ hybridization （FISH） technique had been applied in diagnosis of bladder cancer. Methods FISH and cytological analysis were performed simultaneously on urine - exfoliated cells from 138 patients with hematuria. Chromosomal abnormalities and gene mutation were determined by FISH with probes for chromosomes 3, 7, 17 and pl6. The sensitivity of FISH and cytological examination in diagnosing transitional cell carcinoma of bladder was studied and compared. Results Big and irregular cell nuclei and position effect variegation were seen in some ceils （ P 〈 0.05 ）. In stage T1 bladder cancer, the sensitivity of FISH and cytological analysis was 83.6 % and 31.3 % respectively,while in stage T2 - T4, their sensitivity was 100 % and 55.6 % respectively. Their sensitivity was 36.3 % and 9.1% respectively with grade G1 versus 95.2 % and 42.9 % respectively with grade G2, and the sensitivity was I00 % and 50 % respectively with grade G3 （ P 〈0.05 ） in a comparable manner. There was significant difference in total sensitivity for diagnosis and staging of transitional cell carcinoma of bladder between FISH and cytological examination （ P 〈 0. 05）. Conclusion FISH is more sensitive than cytological examination, hence it may be applied as a valuable method for diagnosing transitional cell carcinoma of bladder.