荧光原位杂交技术在膀胱尿路上皮癌诊断中的价值

目的通过与尿液脱落细胞学检查相比，评估荧光原位杂交技术（FISH）在膀胱尿路上皮癌诊断中的价值。方法选取正常人群中20例和150例膀胱肿瘤患者，同时进行尿脱落细胞检测和FISH检测，并与最终病理结果比较，来确定两种检测方法的敏感性和特异性的差异。结果FISH和尿脱落细胞学检测在诊断膀胱尿路上皮癌上的总的敏感性为86．70％vs35．30％，特异性为95％vs95％。在各个临床分期中的敏感性为T1（84．30％vs34．70％），T2-T4（96．60％vs37．90％），在不同病理分级中的敏感性为G1（64．5％vs19．40％），G2（90．10％vs47．90％），G，（100％vs52．90％）。FISH诊断膀胱尿路上皮癌的总敏感性以及各个临床分期和病理分级上的敏感性均高于尿脱落细胞学检测，并具有统计学差异（P〈0．05）。特异性与尿液脱落细胞学检查相同。结论作为早期诊断膀胱尿路上皮癌的方法，FISH具有无创、安全、高敏感性和高特异性的特点。

The value of fluorescence in situ hybridization in the diagnosis of urothelial bladder cancer

Objective To evaluate the value of fluorescence in situ hybridization （FISH） in the diagnosis of urothelial bladder cancer by comparing the sensitivity and specifity of FISH and urinary cytology. Methods We choosed 150 patients- with bladder cancer and 20 healthy cases were chosed, to undergoing FISH and urine cytological detection, and compare with the pathology. Then we found out the difference in sensitivity and specifity between the two groups. Results The sen- sitivity of FISH and urine cytological examination were 86.70 % and 35.30 %, and the specifity were 95 % and 95 %. The sensitivity of FISH and urine cytological examination in stage Tl were 84.30% and34.70%. Those were 96.60% and37.90% in stage Tz-T,. In grade GI, the sensitivity were 64.5% and 19.40%. Those were 90.10% and 47.90% in grade G：, and 100% and 52.90% in grade G3. The total sensitivity and sensitivities in staging and grading subgroups of FISH were higher than that of urine cytological examination with statistical difference （P 〈 0.05）. The specifity of FISH was the same as that of urine cytological examination. Conclusions FISH is a non-invasive, safe, sensitive and specific method in diagnosis of bladder cancer.