膀胱移行细胞癌的分子细胞遗传学研究

目的　分析膀胱移行细胞癌的染色体畸变。方法　采用 7,9,11,17号染色体着丝粒探针对 34例膀胱移行细胞癌患者尿液、30例膀胱冲洗液的脱落细胞核进行荧光原位杂交 (fluorescenceinsituhybridization ,FISH )研究 ,并同时做了细胞学检查。结果　 (1)膀胱癌患者尿液脱落细胞核中 7,9,11,17号染色体数目畸变阳性率分别为 2 3.5 %、38.2 %、14.7%和 11.8% ;冲洗液中各号染色体畸变阳性率分别为 30 .0 %、5 0 .0 %、2 6 .7%和 16 .7%。其中 9号染色体畸变率较高 ,但与膀胱癌分级、分期无明显关系 ;7号染色体数目畸变与膀胱癌的分期密切相关 ;11,17号染色体数目畸变与膀胱癌分级、分期无显著相关性。 (2 )膀胱癌患者尿液组中尿细胞学、FISH阳性率分别为 2 9.4%和 5 5 .9% ,两种方法联合后阳性率达 6 7.6 % ;膀胱冲洗液组中阳性率则分别为 2 7.6 %和 73.7% ,两种方法联合后阳性率达 80 .0 %。结论　膀胱癌的发生发展与染色体的畸变有关。FISH检测膀胱癌患者尿液、冲洗液脱落细胞间期核染色体数目畸变 ,有可能作为膀胱癌诊断、预后判断的一项辅助方法。

Molecular cytogenetic study of bladder transitional cell carcinoma by FISH

Objective To study the molecular cytogenetic alterations of transitional cell carcinoma of the urinary bladder with exfoliated cells.Methods Fluorescence in situ hybridization (FISH) was performed using centromeric probes of chromosome 7, 9, 11 and 17 to examine chromosome aberration of exfoliated cells in 34 urine samples and 30 bladder washings from patients with transitional cell urinary bladder carcinoma. Results (1) The frequency of numerical aberration of chromosome 7, 9, 11, 17 was 23.5%, 38.2%, 14.7% and 11.8% in urine and 30.0%, 50.0%, 26.7% and 16.7% in bladder washing, respectively. Loss of chromosome 9 was the most common finding, but it was not correlated with pathological grade of cancer and stage of the disease. Abnormality of chromosome 7 was however associated with the clinical stage. (2) The positive rate of examination by cytology and FISH was 29.4%and 55.9% in urine, 27.6% and 73.7% in bladder washing, respectively. When the results of cytology and FISH were combined, the positive rate increased to 67.6% and 80.0% for urine and bladder washing, respectively. Conclusion A number of chromosome aberrations is detected in transitional cell carcinoma of the urinary bladder by FISH technique which provides a basis for further understanding of its molecular pathogenesis and clinical applications.