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目的:通过比较TMPRSS2/ERG融合基因与前列腺癌各项诊断指标的关系,评估荧光原位杂交技术(FISH)诊断和鉴别诊断前列腺癌的临床应用价值。方法:分别对44例前列腺癌及12例BPH石蜡切片行FISH检测TMPRSS2和ETS(ERG、ETV1及ETV4)基因融合现象,比较两种疾病发生基因融合的情况,并分析前列腺癌标本中TMPRSS2/ETS基因融合改变和前列腺癌各项诊断指标的关系。结果:在44例前列腺癌标本中,26例(59.1%)检测到MPRSS2/ERG融合基因,4例(9.1%)检测到MPRSS2/ETV1融合基因;1例(2.3%)检测到MPRSS2/ETV4融合基因。20例BPH标本均未检测到基因融合现象。FISH诊断前列腺癌的敏感性为70.5%,特异性为100%。TMPRSS2/ETS基因融合状态异常与Gleason评分和ECT呈正相关,相关系数分别为0.383(P=0.001)和0.309(P=0.041);MPRSS2/ETS基因异常发生率与DRE和TRUS的阳性检出率无关联(P>0.05)。结论:FISH技术检测TMPRSS2/ETS(ERG、ETV1、ETV4)融合基因在诊断前列腺癌中具有较高的敏感性和特异性,有助于早期前列腺癌的诊断和鉴别诊断。
OBJECTIVE: To evaluate the clinical value of fluorescence in situ hybridization (FISH) in diagnosis and differential diagnosis of prostate cancer by comparing the TMPRSS2 / ERG fusion gene with various diagnostic indicators of prostate cancer. Methods: The fusion of TMPRSS2 and ETS (ERG, ETV1 and ETV4) gene was detected by FISH in 44 cases of prostate cancer and 12 cases of BPH paraffin sections, and the gene fusion between the two diseases was compared. The TMPRSS2 / ETS Relationship between gene fusion and various diagnostic indicators of prostate cancer. Results: The MPRSS2 / ERG fusion gene was detected in 26 cases (59.1%) and the MPRSS2 / ETV1 fusion gene in 4 cases (9.1%) in 44 cases of prostate cancer samples. The MPRSS2 / ETV4 fusion gene was detected in 1 case (2.3%) gene. None of the 20 BPH specimens detected gene fusion. FISH diagnosis of prostate cancer sensitivity was 70.5%, specificity of 100%. The abnormality of TMPRSS2 / ETS gene fusion was positively correlated with Gleason score and ECT, and the correlation coefficients were 0.383 (P = 0.001) and 0.309 (P = 0.041) respectively. The positive rates of MPRSS2 / ETS gene and DRE and TRUS Correlation (P> 0.05). Conclusion: The detection of TMPRSS2 / ETS (ERG, ETV1, ETV4) fusion gene by FISH has higher sensitivity and specificity in the diagnosis of prostate cancer, which is helpful for the diagnosis and differential diagnosis of early stage prostate cancer.