尿脱落细胞吖啶橙染色检查在膀胱癌诊断中的应用价值

目的 探讨尿脱落细胞吖啶橙荧光染色(AO-F)检查在膀胱癌诊断中的应用价值.方法 回顾性分析1016例膀胱癌患者资料,按临床分期、病理分级、肿瘤大小、数目、部位,手术治疗方式及有无血尿症状,分别计算AO-F阳性率,并进行统计学分析.结果 1016例患者尿样AO-F阳性率78.05%(793/1016),表浅癌和浸润癌患者阳性率分别为74.69%(611/818)和91.92%(182/198);病理分级≤Ⅱ级和Ⅲ级患者阳性率分别为67.24%(351/522)和90.37%(413/457);有无血尿症状患者阳性率分别为80.30%(750/934)和52.44%(43/82);肿瘤直径≥2 cm和<2 cm患者阳性率分别为79.87%(710/889)和65.35%(83/127);多发和单发肿瘤患者阳性率分别为83.07%(363/437)和74.27%(430/579);肿瘤累及膀胱三角区或膀胱颈部者阳性率为77.21%(105/136),累及其他部位者为78.07%(687/880);治疗方法TURBt、膀胱部分切除和膀胱全切除患者阳性率分别为69.68%(393/564),87.87%(268/305)和91.74%(100/109).AO-F阳性率与膀胱癌临床分期、病理分级、手术治疗方式、肿瘤大小、数目及有无血尿症状等因素有明显相关性,且与其临床分期、病理分级间存在正相关(r值分别为0.99和0.97);患者性别及肿瘤发生部位等因素与AO-F阳性率之间无相关性.结论 尿脱落细胞AO-F榆查诊断膀胱癌阳性率高,且简便、无创、经济、准确性高,可反复进行,可提高膀胱癌患者的早期诊断率,值得临床推广应用.

Acridine orange fluorescene in diagnosis of bladder cancer

Objective To investigate the diagnostic value of acridine orange fluorescene(AO-F) in bladder cancers. Methods One thousand and sixteen bladder cancer patients were reviewed retro-spectively. The positive-rates of AO-F in different stages, grades, size, quantity, position of tumors, hematuria and treatment ways were evaluated. Results The total positive rate of AO-F was 78.05 % (793/1016). The positive-rate was 74.69% (611/818) in superficial stage and 91.92% (182/198) in invasive bladder cancer, 67.24% (351/522) in grade Ⅰ and Ⅱ , 90. 37% (413/457) in grade Ⅲ. The percentage of positive AO-F was 80.30% (750/934) in patients with hematuria, 52.44% (43/82) in patients without hematuria. The percentage was 79.87% (710/889) when the tumor size was more than 2 cm, 65.35% (83/127) when size less than 2 cm. 83.07% (363/437) sample was positive in multiple tumors, 74.27% (430/579) in single tumor. The percentage was 77.21% (105/136) in tumors involving trigone or neck of bladder, 78.07% (687/880) in tumors without involving these re-gions. There was 69.68% (393/564) in treatment with TURBt, 87.87% (268/305) in partial resec-tion, 91.74% (100/109) in total resection. A good association was observed between stage, grade, hematuria appearance, tumor size, quantity of carcinoma, treatment way and AO-F positive-rate, and a linear correlation was present between grade, stage and positive cytology. There was no significant association between position of the tumor and AO-F positive-rate. Conclusions The function of AO-F is significant in diagnosis of bladder cancer.