RT-PCR法检测尿脱落细胞中XIAP的表达在膀胱癌诊断中的价值

目的：比较膀胱癌患者尿液脱落细胞中XIAP表达的RT-PCR检测法和常规尿脱落细胞病理学检测在膀胱癌诊断中的临床价值。方法：采用逆转录聚合酶链反应技术（RT-PCR）检测51例膀胱尿路上皮癌患者尿液脱落细胞中XIAP-mRNA的表达,同时行常规尿脱落细胞病理学检测,20例非肿瘤人员作为对照组。结果：实验组51例尿脱落细胞XIAP-mRNA RT-PCR检测阳性27例（53%）,尿脱落细胞学病理学检测阳性12例（24%）,对照组20例尿脱落细胞XIAP-mRNA检测阳性1例（5.0%）,对照组尿脱落细胞病理学检测阳性0例（0%）。实验组RT-PCR检测膀胱尿路上皮癌患者尿脱落细胞中XIAP表达的敏感性高于尿脱落细胞病理学检测,差异有极显著统计学意义（P〈0.01）,实验组RT-PCR检测膀胱尿路上皮癌患者尿中XIAP表达的敏感性显著高于非肿瘤对照组,差异有极显著统计学意义（P〈0.01）。结论：膀胱尿路上皮癌患者尿脱落细胞中XIAP表达的RT-PCR检测法较常规尿脱落细胞病理学检测更敏感,临床上作为膀胱癌的筛选方法,有一定的临床价值。     

尿脱落细胞端粒酶活性检测在膀胱癌中的诊断价值

目的：探讨通过检测尿脱落细胞端粒酶活性早期诊断膀胱癌。方法：采用改进的银染－TRAP（端粒重复序列扩增）法,分别对45例膀胱移行细胞癌患者,10例膀胱良性病变患者及8例正常人尿脱落细胞进行了端粒酶活性检测。结果：24例G1级（分化良好）的膀胱癌患者,端粒酶活性强阳性12例,弱阳性6例（阳性率75．0％）,21例G2,G3级膀胱癌患者,强阳性16例,弱阳性3例（阳性率94．5％）,膀胱良性病变患者及正常人尿脱落细胞只有1例端粒酶活性呈弱阳性,其余全部阴性。结论：尿脱落细胞端粒酶活性检测特异性强,敏感性高,与病理分类,组织分级等无明显关系,提示有可能成为膀胱癌临床早期诊断指标之一。     

尿细胞角蛋白检测与尿脱落细胞学检查在膀胱癌诊断中的价值

目的:探讨尿细胞角蛋白检测与尿脱落细胞学检查在膀胱移行细胞癌诊断中的价值。方法:136例怀疑膀胱癌者,进行尿细胞角蛋白8和18的含量(UBC值)。检测与尿细胞学检查,其中87例经组织学证实为膀胱移行细胞癌。比较两者诊断膀胱癌的敏感性和特异性。结果:尿细胞角蛋白的敏感性为70.1%,特异性为73.3%;尿细胞学的敏感性为42.5%,特异性为83.7%。尿细胞角蛋白在膀胱癌不同分级和分期中的敏感性优于尿细胞学(P<0.05)。结论:尿细胞角蛋白的检测在早期诊断膀胱癌方面优于尿细胞学检查,可作为膀胱癌的早期检测指标。     

膀胱移行细胞癌患者尿脱落细胞中MUC7的表达及其临床意义的研究

目的:探讨膀胱移行细胞癌(BTCC)患者尿脱落细胞中MUC7的表达及其临床意义.方法:采用逆转录聚合酶链反应(RT-PCR)检测42例BTCC患者、40例对照者尿脱落细胞中MUC7的mRNA表达,β-actin作为内参照.结果:40例对照组中有2例MUC7 mRNA表达阳性,阳性率为5.0%;42例BTCC患者中36例尿脱落细胞中MUC7 mRNA表达阳性,阳性率为85.7%,其诊断特异性为95%.不同临床分期尿脱落细胞中MUC7 mRNA的阳性表达率:Ta-T1期为64.3%(9/14),T2-4期为96.4%(27/28).浸润性BTCCMUC7的阳性表达率显著高于浅表性BTCC(P＜0.05).不同病理分级BTCC患者尿脱落细胞中MUC7的mRNA的阳性表达率为G158.3%(7/12),G2 93.8%(15/16),G3 100%(14/14).MUC7mRNA的表达与BTCC的病理分级呈正相关.MUC7诊断BTCC的阳性预测值为94.7%,阴性预测值为86.3%.结论:BTCC患者尿脱落细胞中MUC7的阳性表达率明显高于对照组.尿脱落细胞中MUC7表达与临床分期、病理分级呈正相关.采用RT-PCR法检测尿脱落细胞中MUC7表达诊断BTCC的敏感性和特异性好、阳性预测值高,特别对T2-4期肿瘤的诊断敏感性好.     

膀胱移行细胞癌患者尿脱落细胞中MUC7的表达及其临床意义的研究

目的:探讨膀胱移行细胞癌(BTCC)患者尿脱落细胞中MUC7的表达及其临床意义。方法:采用逆转录聚合酶链反应(RT-PCR)检测42例BTCC患者、40例对照者尿脱落细胞中MUC7的mRNA表达,β-actin作为内参照。结果:40例对照组中有2例MUC7 mRNA表达阳性,阳性率为5．0％;42例BTCC患者中36例尿脱落细胞中MUC7 mRNA表达阳性,阳性率为85．7％,其诊断特异性为95％。不同临床分期尿脱落细胞中MUC7 mRNA 的阳性表达率:Ta-T1期为64．3％(9／14),T2-4期为96．4％(27／28)。浸润性BTCC MUC7的阳性表达率显著高于浅表性BTEC(P<0．05)。不同病理分级BTCC患者尿脱落细胞中MUC7的mRNA的阳性表达率为C1 58．3％(7／ 12),C2 93．8％(15／16),G3 100％(14／14)。MUC7 mRNA的表达与BTCC的病理分级呈正相关。MUC7诊断BTCC 的阳性预测值为94．7％,阴性预测值为86．3％。结论:BTCC患者尿脱落细胞中MUC7的阳性表达率明显高于对照组。尿脱落细胞中MUC7表达与临床分期、病理分级呈正相关。采用RT-PCR法检测尿脱落细胞中MUC7表达诊断BTCC的敏感性和特异性好、阳性预测值高,特别对T2-4期肿瘤的诊断敏感性好。     

RT-PCR在胃癌微转移诊断中的应用

逆转录一聚合酶链反应(RT-PCR)方法被用于检测胃癌微转移病灶中特殊的mRNA表达，可以发现早、中期胃癌根治术后患者的微小转移灶，对肿瘤分期、指导治疗、判断预后等有重要临床意义。现综述RT-PCR在胃癌微转移中的检测及其临床意义.     

实时荧光定量RT-PCR技术在肿瘤研究中的应用

实时荧光定量RT-PCR以其特异性强、灵敏度高、重复性好、定量准确、速度快、全封闭反应等优点而成为了分子生物学研究中的重要工具,广泛应用于医学等领域.全文就其原理、优越性及其在肿瘤研究中的应用及发展前景作一简要叙述.     

检测尿脱落细胞CK20表达的临床意义

目的探讨尿路移行细胞癌(TCC)患者尿脱落细胞CK20的表达及其意义.方法采用逆转录聚合酶链反应(RT-PCR)检测38例TCC患者、6例泌尿系非移行细胞癌肿瘤患者、14例泌尿科非肿瘤患者以及7例健康志愿者尿脱落细胞CK20表达.以GAPDH作为内参照.结果38例TCC患者中33例尿脱落细胞CK20阳性表达,阳性率为86.8%.6例泌尿系非移行细胞癌肿瘤患者、14例泌尿科非肿瘤患者以及7例健康志愿者尿脱落细胞CK20表达阴性.结论检测尿脱落细胞CK20表达诊断TCC敏感性和特异性高,可作为TCC筛查的方法之一.     

尿脱落细胞LewisX检测诊断膀胱尿路上皮癌的价值

目的：探讨LewisX抗原在膀胱尿路上皮癌非侵袭性诊断中的应用价值。方法：采用EnVision免疫细胞化学方法，检测52例膀胱尿路上皮癌和16例非肿瘤患者尿脱落细胞标本中LewisX抗原的表达情况，并与细胞病理学检测结果相比较。结果：尿路上皮癌诊断的敏感性和特异性分别为84．6％和87．5％，其敏感性显著高于细胞病理学。结论：尿脱落细胞LewisX抗原免疫染色，是检测膀胱尿路上皮癌可行的较敏感的非侵袭性方法。     

RT-PCR在胃癌微转移诊断中的应用

逆转录-聚合酶链反应(RT-PCR)方法被用于检测胃癌微转移病灶中特殊的mRNA表达,可以发现早、中期胃癌根治术后患者的微小转移灶,对肿瘤分期、指导治疗、判断预后等有重要临床意义.现综述RT-PCR在胃癌微转移中的检测及其临床意义.     

尿液P16基因甲基化对浅表性膀胱移行细胞癌早期诊断的意义

目的探讨P16基因甲基化在浅表性膀胱移行细胞癌发生早期的临床意义。方法取42例膀胱移行细胞癌组织及配对尿液标本,以其中9例的对侧正常膀胱黏膜组织作对照,采用甲基化特异性PCR方法检测P16基因CpG岛甲基化状态。结果35例肿瘤组织标本,18例P16基因CpG岛存在甲基化状态,占51.4%（18/35）;尿液标本中,16例P16基因CpG岛存在甲基化状态,占45.7%（16/35）。Log istic回归分析显示年龄、性别、是否吸烟、合并其他疾病、肿瘤的临床分期和病理分型等因素对P16基因甲基化无影响（P〉0.05）。20例浅表性膀胱移行细胞癌患者的尿液标本中发现P16基因甲基化10例,其配对的浅表性膀胱移行细胞癌组织中均检出P16基因甲基化,正常人和非尿路肿瘤患者尿液中未检出到P16基因甲基化,尿液P16基因甲基化在浅表性膀胱移行细胞癌中的阳性预测值和特异度均为100%,假阳性为0%,灵敏度为90.91%。正常人组和非尿路肿瘤组与浅表性膀胱移行细胞癌组尿液中P16基因甲基化比较差异有统计学意义（P〈0.001）,9例正常组织对照均未发现P16基因CpG岛甲基化。结论P16基因甲基化与年龄、性别、肿瘤的分级分期无相关性;尿液P16基因异常甲基化可成为浅表性膀胱移行细胞癌早期诊断的分子生物学标志。     

应用定量PCR方法动态检测膀胱癌患者尿脱落细胞中survivin mRNA的表达及其临床意义

背景与目的：膀胱癌是泌尿系统最常见的恶性肿瘤,目前临床上缺乏理想的早期诊断方法。本研究通过检测膀胱移行细胞癌（bladder transitional cell carcinoma,BTCC）患者手术前后尿脱落细胞中survivinm RNA的表达,探讨其在BTCC患者早期诊断和术后监测肿瘤复发中的意义。方法：采用实时荧光定量PCR（real-time PCR）法检测10例健康志愿者、15例膀胱炎患者和30例初发BTCC患者术前及术后1周、1个月、6个月定期随访至15个月尿脱落细胞中survivin mRNA的表达情况。结果：30例BTCC患者术前尿脱落细胞中survivin mRNA的相对拷贝数为96．01±42．33。明显高于正常对照组及膀胱炎组（P〈0．05）。术后1周（25．30±1．51）较术前显著下降（P〈0．05）;术后1个月（13．20±1．49）、术后6个月（13．90±1．36）与正常对照组比较差异均无统计学意义（P〉0．05）;随访至15个月,3例复发患者复发时的相对拷贝数为97．83±27．47,与术后6个月相比差异有统计学意义（P〈0．05）。结论：尿脱落细胞中survivin mRNA的表达作为诊断膀胱移行细胞癌的指标敏感性高,术后动态随访survivin mRNA表达变化可监测复发。     

Alterations in tropomyosin isoform expression in human transitional cell carcinoma of the urinary bladder

Previous studies of transformed rodent fibroblasts have suggested that specific isoforms of the actin-binding protein tropomyosin (TM) could function as suppressors of transformation, but an analysis of TM expression in patient tumor tissue is limited. The purpose of our study was to characterize expression of the different TM isoforms in human transitional cell carcinoma of the urinary bladder by immunohistochemistry and Western blot analysis. We found that TM1 and TM2 protein levels were markedly reduced and showed >60% reduction in 61% and 55% of tumor samples, respectively. TM5, which was expressed at very low levels in normal bladder mucosa, exhibited aberrant expression in 91% of tumor specimens. The Western blot findings were confirmed by immunohistochemical analysis in a number of tumors. We then investigated the mechanism underlying TM expression deregulation, in the T24 human bladder cancer cell line. We showed that levels of TM1, TM2 and TM3 are reduced in T24 cells, but significantly upregulated by inhibition of the mitogen-activated protein kinase-signaling pathway. In addition, inhibition of this pathway was accompanied by restoration of stress fibers. Overall, changes in TM expression levels seem to be an early event during bladder carcinogenesis. We conclude that alterations in TM isoform expression may provide further insight into malignant transformation in transitional cell carcinomas of the bladder and may be a useful target for early detection strategies.     

Metachronous bladder tumors in patients with upper urinary tract transitional cell carcinoma

Sixty-nine patients who underwent nephroureterectomy for upper urinary tract transitional cell carcinoma were included in the study. The following data were collected for each patient: grade and stage of renal/ureteral tumor, tumor location, timing of tumor appearance and recurrence in the bladder, grade and stage of each of the recurrent tumors, and number of recurrences. Follow-up ranged between 2 and 15 years. Thirty-three patients (47.8%) developed metachronous bladder tumors. The appearance of the bladder tumors was related to tumor grade and multifocality of the upper urinary tract TCC. Of the 33 patients, 19 had 1 tumor appearance in the bladder, 6 had 2 recurrences, and 8 had 3 recurrences. The 5-year survival rate for patients with no subsequent bladder tumors was 57% compared to 22% for those who had subsequent tumors. It is concluded that the appearance of bladder tumors following nephroureterectomy characterizes a group of patients with biologically more active disease with unfavorable prognosis. © 1994 Wiley-Liss, inc.     

膀胱癌抗原在膀胱移行细胞癌诊断中的价值

目的评价膀胱癌抗原(UBC)对膀胱移行细胞癌(BTCC)的诊断价值.方法采用ELISA法对89例BTCC及108例泌尿系非移行细胞癌(TCC)患者的尿UBC进行检测,并同时行尿脱落细胞学检查.结果 BTCC患者尿UBC均值为30.5 μg/L,与泌尿系非TCC患者8.2μg/L的均值比较,差别有显著性意义(P＜0.01).尿UBC(以8.4μg/L为最适临界值)和尿细胞学诊断BTCC的敏感性分别为75.3%和16.9%,特异性分别为77.8%和100%,两者差别均有显著性意义(P＜0.01).结论尿UBC检测对BTCC的诊断是一种较为敏感、特异且无创的方法,敏感性明显优于尿细胞学,但临床上不能完全替代尿细胞学检查.     

Selective bladder preservation for muscle-invasive transitional cell carcinoma of the urinary bladder

Invasive transitional cell carcinoma (TCC) of the urinary bladder is traditionally treated with radical cystectomy. This approach results in great morbidity and lifestyle changes, and approximately half of the patients treated in this way will experience recurrent TCC despite surgery. An alternative approach using selective bladder-preservation techniques incorporates transurethral resection of bladder tumours, radiation therapy, and chemotherapy. Over the past 20 years, international experience has demonstrated that this approach is feasible, safe, and well tolerated. Furthermore, the long-term outcomes of overall survival and disease-free survival compare favourably with the outcomes from radical cystectomy. The most important predictor of response is stage, with significantly higher long-term survival in patients with T2 disease. Another important positive predictor of complete response to therapy is the ability of the urologic oncologist to remove all visible tumour through a transurethral approach prior to initiation of radiation therapy. A negative predictive factor is the presence of hydronephrosis, and age and gender do not affect disease-free survival. The majority of patients who enjoy long-term survival do so with an intact native bladder. Quality of life studies have demonstrated that the retained bladder functions well in nearly all of these patients. Selective bladder preservation will not entirely take the place of radical cystectomy, but should be offered as an important alternative to patients newly diagnosed with muscle-invasive TCC.     

多排螺旋CT在膀胱癌诊断中应用价值的探讨

目的:探讨多排螺旋CT(MSCT)增强扫描在膀胱癌诊断及分期的价值。方法:应用MSCT对46例膀胱癌患者进行增强前后容积扫描,所得数据在工作站利用软件进行后处理,重建MPR、MIP及3D等图像。并对MSCT(后处理重建图像)图像、IVP、B超及膀胱镜检查比较分析。结果:四种检查方法对膀胱癌诊断存在明显差异,其敏感性依次为:膀胱镜检>CT>超声>IVP;MSCT增强、薄层扫描及图像重建在发现<5 mm病灶及分期方面有重要意义,MSCT分期与术后病理分期准确率达84．78％。结论:MSCT在膀胱癌诊断及分期中是一种较可靠的非侵入性检查方法,MSCT增强及图像后处理重建在膀胱癌的诊断及分期中有较高的准确性。     

Coexisting leiomyosarcoma and transitional cell carcinoma of the urinary bladder

A rare case of coexisting sarcoma and carcinoma of the urinary bladder is reported and the literature is reviewed. Because of the differences in the histogenesis and prognosis, such cases should be differentiated from cases of carcinosarcoma of the urinary bladder.     

原癌基因c-erbB-2在膀胱移行细胞癌中表达的意义

 本文应用免疫组织化学S-P法对40例膀胱移行细胞癌石蜡组织C-erbB-2基因表达与病理分级、临床分期和复发之间的关系进行研究,结果膀胱移行细胞癌C-erbB-2基因表达阳性率为40%.Ⅲ级与Ⅰ级、Ⅱ级肿瘤间存在显著性差异(PPP<0.05).提示C-erbB-2基因表达对判断膀胱癌预后有-定临床价值.