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目的应用荧光原位杂交((fluorescence in situ hybridization,FISH)技术检测膀胱癌患者尿液脱落细胞中染色体异常,评估FISH在中国人群中诊断膀胱癌的作用。方法2007年1月至2008年8月,随机留取20例良性前列腺增生症患者的新鲜尿液,用3号和7号、17号及p16位两组混合探针,通过在尿液脱落细胞标本上进行FISH检测,建立正常人群的阈值;其后随机留取30例门诊膀胱镜活检证实的膀胱癌患者的尿液,同时进行尿液脱落细胞的细胞形态学分析及FISH检测,对比检查结果。结果3号、7号和17号染色体非整倍性改变及p16位点异常正常阈值分别为8.5%、7.1%、6.8%和9.2%,FISH与细胞学检查总敏感性分别为76.6%和43.3%(P<0.05)。T_(is)及T_a、T_1患者FISH检测的敏感性分别为80.0%和64.2%,脱落细胞组织学检测显示敏感性分别为40.0%和35.7%;T_(2-3)患者FISH的敏感性为90.9%,而脱落细胞组织学检测为54.7%(P<0.05),低级别尿路上皮癌FISH及细胞学敏感性分别为68.4%和31.6%;高级别分别为90.9%和63.6%。结论与尿液脱落细胞组织学检测相比,对尿液脱落细胞进行FISH检测可以提高膀胱癌的诊断率,FISH可以作为诊断膀胱癌的一种无创伤的新方法。
Objective To detect chromosomal abnormalities in urine exfoliated cells of patients with bladder cancer by fluorescence in situ hybridization (FISH) and to evaluate the role of FISH in the diagnosis of bladder cancer in Chinese population.Methods From January 2007 to August 2008 , 20 cases of benign prostatic hyperplasia were randomly collected fresh urine, with 3 and 7, 17 and p16 two sets of mixed probe, urine exfoliated cells by FISH test to establish the normal population Thirty patients with bladder cancer confirmed by out-patient cystoscopy biopsy were randomly enrolled in this study.At the same time, morphological analysis of urine exfoliated cells and FISH were performed to compare the results.Results No.3, No.7 and No.17 The average thresholds of chromosomal aneuploidy and p16 abnormalities were 8.5%, 7.1%, 6.8% and 9.2%, respectively. The total sensitivity of FISH and cytology was 76.6% and 43.3%, respectively (P <0.05) The sensitivity of FISH in T_a and T_1 patients was 80.0% and 64.2%, respectively. The sensitivity of exfoliated cells was 40.0% and 35.7% respectively. The sensitivity of FISH in T_ (2-3) patients was 90.9% , While exfoliated cells were detected in 54.7% (P <0.05) and low grade urine The FISH and cytological sensitivity of epithelial carcinoma were 68.4% and 31.6%, respectively, and the high grade were 90.9% and 63.6%, respectively.Conclusion FISH of exfoliated urine cells can improve bladder cancer compared with histological examination of urine exfoliated cells The diagnostic rate, FISH can be used as a diagnosis of bladder cancer a non-invasive new method.