荧光原位杂交技术在膀胱癌诊断中的临床应用研究

目的探讨利用荧光原位杂交（fluorescence in situ hybridization，FISH）技术提高早期诊断膀胱癌的可能性。方法收集20例健康成人的晨尿用FISH技术检测3号、7号、9号p16位点和17号染色体的变异情况，统计出相应阈值。收集100例膀胱癌疑似患者的晨尿，分别进行尿脱落细胞学检查和FISH技术检测。统计学方法分析FISH技术的敏感性、特异性及与膀胱癌发生、发展的关系。结果100例膀胱癌疑似患者的尿液FISH检测的敏感度为87．50％，特异度为80．00％，总阳性率为79．00％；尿脱落细胞学检查的敏感度为61．54％，特异度为83．33％，总阳性率为49．00％。两种检测方法在敏感度和总阳性率上的差异均具有统计学意义，特异度上差异无统计学意义。FISH检测与膀胱癌的病理分级和临床分期均无相关性。结论FISH技术能成为一种提高中国人群膀胱癌早期诊断及监测膀胱癌预后的新方法。

The clinical application of fluoresence in situ hybridization in diagnosis of bladder neoplasms

Objective To improve early diagnosis of carcinoma of bladder with in situ hybrid- ization technology. Methods Twenty specimen were collected from healthy people. The abnormality of the third, 7th, 17th, and P16 dot at 9th chromosome were detected with FISH technology. The corresponding threshold is calculated. Fresh urine samples from 100 patients suspect of carcinoma of bladder were collected and detected with exfoliocytology and FISH technology. The sensitivity, specificity and relations with development of carcinoma of bladder is analyzed. Results The sensitivity and specificity of FISH were 87.50% and 80.00%, respectively, with the total positive rate being 79.00% . The sensitivity and specificity of urine exfoliocytology were 61.54% and 83. 33%, respectively, with total positive rate being 49.00%. Significant difference had been noted in the sensitivity and the total positive rate hut specificity between the FISH and exfoliocytology detection. The FISH examination and the elevation of graduation of carcinoma of bladder have no significant difference. Conclusions FISH technology will he a new and excellent detecting technology to increase the early diagnosis rate and prodict the prognosise of carcinoma of bladder.