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目的探讨荧光原位杂交(FISH)技术运用于膀胱尿路上皮癌的诊断价值。方法收集20例健康志愿者的新鲜晨尿,运用荧光标记的3号、7号、17号染色体着丝粒探针及9号染色体p16位点探针,对尿液标本中的脱落细胞染色体进行FISH技术检测,建立正常人群的阈值。收集158例怀疑为膀胱尿路上皮癌患者的新鲜晨尿,在行膀胱镜检查前,同期进行FISH技术与尿脱落细胞学检测,运用统计学方法,比较FISH技术与尿脱落细胞学检测的敏感性与特异性。结果 FISH与尿脱落细胞学的敏感性分别为84.8%和43.8%,FISH敏感性高于尿脱落细胞(P<0.05),FISH与尿脱落细胞学特异性分别为89.1%和87.0%,两者无统计学差异(P>0.05),在不同的肿瘤病理分级中,FISH的敏感性都高于尿脱落细胞,并且FISH敏感性随肿瘤分级逐级升高(P<0.05)。结论 FISH技术具有较高的敏感性和特异性,可以作为国人膀胱尿路上皮癌筛查、诊断的新方法。
Objective To investigate the diagnostic value of fluorescence in situ hybridization (FISH) in bladder urothelial carcinoma. Methods Fresh morning urine was collected from 20 healthy volunteers. The chromosomes of exfoliated cells in urine samples were detected by fluorescently labeled centromere probes 3, 7, 17 and p16 locus on chromosome 9 FISH technology testing to establish the threshold of normal population. 158 cases of bladder urothelial carcinoma were collected fresh morning urine, before cystoscopy, FISH and urine cytology during the same period, the use of statistical methods to compare the sensitivity of FISH and urine cytology detection Sexual and specific. Results The sensitivity of FISH to exfoliative cytology was 84.8% and 43.8%, respectively, and the sensitivity of FISH to exfoliated cells was higher than that of urine exfoliated cells (P <0.05). The cytological specificity of FISH and exfoliated urine were 89.1% and 87.0%, respectively There was no statistical difference (P> 0.05). The sensitivity of FISH was higher than that of exfoliated cells in different tumor pathological grades, and the sensitivity of FISH increased gradually with the tumor grade (P <0.05). Conclusion FISH has high sensitivity and specificity and can be used as a new method for screening and diagnosing bladder cancer in urinary bladder in China.