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目的应用荧光原位杂交技术(FISH)检测膀胱尿路上皮癌患者尿液脱落细胞中染色体异常,探讨FISH在膀胱尿路上皮癌诊断的可行性。方法 2007年10月至2009年4月,随机留取20例正常人群的新鲜尿液及91例疑似尿路移行上皮肿瘤患者的肉眼血尿,其中男性66例,女性25例。同时行FISH检测和尿液脱落细胞学分析,FISH检测使用荧光标记DNA探针混合物与细胞核上3、7、17号染色体及9p16位点杂交,并与病理检查结果进行比较。结果 91例行FISH检测的患者,通过膀胱镜活检或手术后病理检查明确诊断为膀胱癌患者83例,其敏感度为97.6%,特异度为92.9%。G1、G2、G3级敏感性分别为93.8%9、7.9%、100%,Ta、T1、T2、T3-4各期的敏感度分别为75%、91.7%、100%、100%。尿脱落细胞学总的敏感度为43.4%,特异度为92.9%。结论 FISH的检测为膀胱尿路上皮癌的早期诊断提供了快速、安全、灵敏度高的非侵犯性检测方法。
Objective To detect chromosomal abnormalities in urine exfoliated cells of patients with bladder urothelial carcinoma by fluorescence in situ hybridization (FISH) and to investigate the feasibility of FISH in the diagnosis of bladder urothelial carcinoma. Methods From October 2007 to April 2009, gross hematuria of 20 fresh urine samples from normal population and 91 patients with suspected urothelial carcinoma were retrospectively analyzed, including 66 males and 25 females. At the same time, FISH and urine exfoliation cytology were performed at the same time. The FISH assay was used to hybridize with chromosome 3,7,17 and 9p16 on the nucleus by fluorescently labeled DNA probe mixture and compared with pathological results. Results Totally 91 patients with bladder cancer were diagnosed as bladder cancer by biopsy or postoperative pathological examination. The sensitivity and specificity of 91 cases were 97.6% and 92.9% respectively. The sensitivities of G1, G2 and G3 were 93.8%, 9.7.9% and 100% respectively. The sensitivity of Ta, T1, T2 and T3-4 were 75%, 91.7%, 100% and 100% respectively. The total sensitivity of exfoliative cytology was 43.4% and the specificity was 92.9%. Conclusion The FISH detection provides a fast, safe and sensitive noninvasive detection method for the early diagnosis of bladder urothelial carcinoma.