尿脱落细胞3、7、17号染色体和9p21位点畸变预测尿路上皮癌复发

目的了解膀胱尿路上皮癌患者术后3、7、17号染色体和9p21位点畸变,并探讨其对尿路上皮癌复发的预测价值。方法用多色荧光原位杂交(multicolor fluorescence in situ hybridization,M-FISH)试剂盒(UroVysion)检测37例尿路上皮癌术后无病生存的随访患者和10例健康人尿液脱落细胞中3、7、17号染色体和9p21位点畸变情况,并分析其预测癌变复发的价值。结果膀胱癌复发组3、7、17号染色体和9p21位点的总畸变率分别为31.66%、40.14%、19.20%和21.24%,复发与未复发患者染色体畸变率差异具有显著意义的表型包括3、7、17号染色体多倍体以及7、17号染色体纯合缺失。37例患者术后复发8例,M-FISH检出6例阳性,敏感性为75.0%,特异性为79.3%,阳性检出时间比膀胱镜和尿脱落细胞学检查提早1～12个月。结论 M-FISH技术有助于预测尿路上皮癌术后复发,3、7、17号染色体畸变对术后复发具有预测价值。

Aberrations of chromosome 3, 7, 17 and 9p21 locus in urine exfoliated cells as predictive factors for recurrence of urothelial carcinoma

Objective To monitor the aberrations of chromosome 3,7,17 and 9p21 locus in the patients with bladder cancer and investigate the prognostic value of the aberrations for recurrence of urothelial carcinoma.Methods Aberrations of chromosome 3,7,17 and 9p21 locus in urine exfoliated cells from 37 disease-free survivals after surgery for bladder cancer and 10 healthy controls were identified by using multicolor fluorescence in situ hybridization(M-FISH) kit(UroVysion).The difference of aberrations between recurrence and without-recurrence group was analyzed and the prognosis of the aberrations for recurrence was evaluated.Results The total aberration rates of chromosome 3,7,17 and 9p21 in voided urine cells from the patients suffered from recurrent urothelial carcinoma were 31.66%,40.14%,19.20% and 21.24% respectively.The significant differences of aneuploid patterns between recurrence and without-recurrence group included polyploidy of chromosome 3,7 and 17 and homozygous deletion of chromosome 7 and 17.Among the 8 patients who were clinically diagnosed as recurrent urothelial carcinoma 6 cases were detected as M-FISH-positive.The sensitivity and specificity of M-FISH for recurrence were 75.0% and 79.3% respectively.The diagnosis of recurrence verified by M-FISH was 1 to 12 months earlier than that by cystoscopy and urine cytology.Conclusion M-FISH could be a useful prognostic tool for recurrence of the urothelial carcinoma in the patients after surgery for bladder cancer.Aberrations in chromosome 3,7 and 17 was associated with recurrence of bladder cancer and was of prognostic value.