荧光原位杂交技术在膀胱尿路上皮癌术后复发的早期检测中的临床应用价值

目的：应用荧光原位杂交技术（fluorescence in situ hybridization,FISH）对膀胱尿路上皮肿瘤患者术后复发进行早期评估预测。方法2009年1月至2011年11月,选取首都医科大学附属北京同仁医院40例临床诊断的高危膀胱尿路上皮癌患者,术后第3,6,9,12,18个月行尿细胞学检查、膀胱镜检查,并行尿液 FISH 检查,记录膀胱肿瘤复发的时间。观察 FISH 对于膀胱尿路上皮肿瘤患者术后复发的早期预测价值。结果60%（12/20）的 FISH 阳性者膀胱肿瘤复发,FISH 阴性者无1例出现膀胱肿瘤复发。 FISH 阳性者膀胱尿路上皮癌复发率高于 FISH 阴性者（60% vs 0%,P〈0.05）。6例（50%）肿瘤复发患者 FISH 阳性先于膀胱镜检查及尿细胞学检查。结论 FISH 对膀胱肿瘤检测的阳性率高于细胞学检测,FISH 对膀胱肿瘤的诊断早于膀胱镜和细胞学。 FISH 技术可作为膀胱尿路上皮肿瘤术后复发的监测指标之一。

Clinical value of fluorescence in situ hybridization in early detection of postoperative recurrence of bladder urothelial cancer

Objective To early diagnose postoperative recurrence of bladder urothelial cancer with fluorescence in situ hybridization （FISH）. Methods Forty patients with bladder urothelial cancer were chosen between January, 2009 and November, 2011. Urine cytologic examination, cystoscopy, and FISH were performed in these patients at 3, 6, 9, 12, and 18 months post-operation, and tumor recurrence was recorded. Results Among the 40 patients tested, 12 of 20 FISH-positive patients developed tumor recurrence within the follow-up period, while none of the FISH-negative patients developed recurrence during the same period. The recurrence rate in FISH-positive patients（60% ） was significantly higher than that of FISH-negative patients（P〈0. 05）. The sensitivity to detect tumor recurrence by FISH analysis was higher than that by cystoscopy and urine cytologic examination. Conclusion FISH analysis is effective in early detection of postoperative recurrence of bladder urothelial cancer.