摘要
目的通过回顾性分析尿脱落细胞的荧光原位杂交在尿路上皮癌中的应用:评价FISH诊断尿路上皮癌的价值及意义.方法选取山东省立医院泌尿微创中心于2012年8月至2017年12月行尿脱落细胞FISH检测的850例患者中,选取经FISH检测结果阳性、并经病理学确诊的160例患者的临床资料,总结其临床病理特点.采用FISH技术检测尿路上皮癌细胞染色体畸变情况,采用卡方检验对肿瘤的分期和分级进行比较,探讨尿脱落细胞荧光原位杂交检查阳性在尿路上皮癌中的临床应用价值及意义.结果经统计,男性患者比例显著高于女性患者,且发病年龄较高.在尿路上皮肿瘤患者中,血尿是最多见的就诊原因.在血尿患者中,本研究FISH诊断尿路上皮癌的阳性预测值为63.1%.在肿瘤类型与肿瘤病理分级的相关性分析上,输尿管癌、肾盂癌及膀胱癌之间无统计学差异.在与肿瘤分期相关性分析上,不同的肿瘤类型之间存在明显差异.FISH检测结果显示3、7、17号染色体及9号染色体p16位点在尿路上皮癌中均有较高的畸变率,3、7及17号染色体突变在不同肿瘤类型中无统计学差异,9号染色体的p16位点畸变类型(包括缺失与扩增)在不同肿瘤类型中也无统计学差异.FISH检测3、7及17号染色体不同突变类型与病理分级没有统计学差异;9号染色体p16位点与与病理分级之间存在统计学差异.染色体突变类型与病理分期也无统计学差异.结论尿脱落细胞的FISH检测可以作为一种尿路上皮肿瘤的非侵入性诊断工具,对尿路上皮癌的早期筛查、诊断与复发监测均有较高的应用价值.此外,9号染色体突变的出现以及突变类型的区别,可以作为评估尿路上皮癌肿瘤分级的一项检测指标.
Objective The objective of this research was to evaluate the significance of positive FISH in urothelial carcinoma by analyzing the aberration of chromosomes of voided urine specimens with FISH.Methods The clinical data of 160 patients with positive FISH test results and confirmed by pathology were selected from 850 patients who underwent FISH detection in the urological minimally invasive center of Shandong provincial hospital from August 2012 to December 2017,and their clinicopathological characteristics were summarized.The chromosomal aberrations of urinary epithelial carcinoma cells were detected by FISH,and the staging and grading of tumors were compared by chi-square test,so as to explore the clinical value and significance of fluorescence in situ hybridization of urine exfoliated cells in urinary epithelial carcinoma.Results Of the 160 patients,the proportion of male patients is significantly higher than that of female patients.Hematuria is the most common reason in patients with urothelial neoplasm.In patients with hematuria,the positive predictive value(PPV)of FISH for the diagnosis of urothelial carcinoma was 63.1%in this study.In the correlation analysis between tumor type and tumor pathological grading,there was no statistical difference between ureteral cancer,renal pelvis cancer and bladder cancer.In the correlation analysis between tumor type and tumor staging,there were significant differences among different tumor types.CSP3,CSP7,CSP17 and GLPp16 FISH tests showed high aberration rate in urothelial carcinoma.CSP3,CSP7,CSP17 mutations had no statistical difference in the different tumor types,aberration of p16 loci of chromosome9(including missing and amplification)also had no statistical difference in different types of tumors.There was no statistical difference in different mutation types of CSP3,CSP7,CSP17detected by FISH and pathological grades.There was a statistical difference GLPp16 and pathological grading.There was no statistical difference in chromosome mutation type and pathological stage.Conclusions FISH detection of urinary exfoliated cells can be used as a non-invasive diagnostic tool for urothelial carcinoma,which has high application value in the early screening,diagnosis and recurrence monitoring of urothelial carcinoma.In addition,the occurrence of chromosome 9 mutations and the differences in the types of mutations can be used as a test indicator to evaluate the grade of urothelial carcinoma.
作者
赖斌
赵勇
冯峰
金讯波
张海洋
Lai Bin;Zhao Yong;Feng Feng;Jin Xunbo;Zhang Haiyang(Department of Urology,Shandong Provincial Hospital affiliated to Shandong First Medical University,Jinan,Shandong,250014,China)
出处
《泌尿外科杂志（电子版）》
2020年第2期31-36,30,共7页
Journal of Urology for Clinicians(Electronic Version)
基金
山东省自然科学基金(ZR2018QH001)资助
关键词
尿路上皮癌
尿脱落细胞
荧光原位杂交技术
Urothelial carcinoma
Urinary exfoliated cells
Fluorescence in situ hybridization
