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目的:分析荧光原位杂交技术(FISH)诊断上尿路的尿路上皮癌的敏感性和特异性,进一步评估FISH检测上尿路尿路上皮癌的临床意义。方法:回顾性分析144例临床疑似的上尿路尿路上皮癌病例FISH检测结果,将各组FISH检测结果与病理学结果进行对照比较,总结FISH检测上尿路尿路上皮癌的敏感性和特异性。结果:病理诊断尿路上皮癌101例(肾盂癌49例、输尿管癌47例、肾盂合并输尿管癌5例)、尿路上皮良性病变33例,另有10例病理诊断为肾细胞癌。101例尿路上皮癌中,FISH阳性55例、阴性46例;FISH敏感性为54.5%。33例良性病例中,阴性31例、FISH阳性2例,特异性为93.9%。FISH检测高级别上尿路尿路上皮癌敏感性为58.9%;低级别肿瘤敏感性28.6%;10例肾细胞癌中透明细胞癌8例,乳头状肾细胞癌2例,其中FISH阳性4例、阴性6例。结论:FISH对于检测上尿路的尿路上皮癌具有较高的敏感性和高度特异性,是临床诊断上尿路的尿路上皮癌的一种重要的无创检查手段。
OBJECTIVE: To analyze the sensitivity and specificity of fluorescence in situ hybridization (FISH) for the diagnosis of urothelial carcinoma in the upper urinary tract and further evaluate the clinical significance of FISH in detecting upper urinary tract urothelial carcinoma. Methods: A retrospective analysis of 144 cases of clinically suspected cases of upper urinary tract urothelial carcinoma FISH test results, the FISH test results of each group compared with the pathological results were compared FISH detection of urinary tract epithelial cancer sensitivity and Specificity. Results: Pathological diagnosis of urothelial carcinoma in 101 cases (49 cases of renal pelvis, ureteral cancer in 47 cases, 5 cases of ureteropelvic ureter), urothelial benign lesions in 33 cases, and another 10 cases of pathological diagnosis of renal cell carcinoma. In 101 cases of urothelial carcinoma, FISH was positive in 55 cases and negative in 46 cases. FISH sensitivity was 54.5%. Of the 33 benign cases, 31 were negative, 2 were positive for FISH, and the specificity was 93.9%. FISH detection of high-grade upper urinary tract urothelial carcinoma sensitivity was 58.9%; low-grade tumor sensitivity 28.6%; 10 cases of renal cell carcinoma in 8 cases of clear cell carcinoma, papillary renal cell carcinoma in 2 cases, including FISH positive in 4 cases , Negative in 6 cases. Conclusion: FISH is highly sensitive and highly specific for the detection of urothelial carcinoma in the upper urinary tract. It is an important non-invasive method for the diagnosis of urothelial carcinoma in the upper urinary tract.