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目的探讨用UroVysion探针标记的荧光原位杂交(FISH)技术在中国人群中诊断上尿路上皮癌的应用价值。方法留取70例因血尿或影像学提示病变的可疑上尿路上皮癌患者尿液标本,分别行UroVysionFISH,检测尿液脱落细胞3、7、17号染色体着丝粒探针及9号染色体p16位点探针,同时行尿细胞学检查,比较UroVysionFISH和尿液脱落细胞二者差异。结果 70例可疑患者中术后病理确诊为上泌尿系尿路上皮癌患者共61例,其中UroVysionFISH和尿细胞学检查阳性例数分别为44例和19例,其敏感性分别为72.1%和31.1%,差异有统计学意义(P<0.005),二者的特异性均为90%。UroVysionFISH和尿细胞学检查对非肌层浸润性肿瘤和肌层浸润性肿瘤的敏感度分别为63.6%、82.1%和24.2%、39.3%,对G1、G2、G3期上尿路上皮癌患者的敏感度分别为41.2%、76.2%、91.3%和11.8%、23.8%、52.2%。结论 UroVys-ionFISH检查为中国人群上尿路上皮癌的早期诊断和术后监测提供了快速、安全、灵敏度高的无创伤性检测方法。
Objective To investigate the value of UroVysion-labeled fluorescence in situ hybridization (FISH) in diagnosis of upper urothelial carcinoma in Chinese population. Methods Urine specimens from 70 patients with suspicious upper urothelial carcinoma who had pathological changes of hematuria or radiology were collected. UroVysion FISH was performed to detect the centromeric probes of exfoliated cells 3,7 and 17 and the chromosome 9 Site probe, at the same time urinary cytology to compare the difference between UroVysionFISH and urine exfoliative cells. Results Among 70 suspicious patients, 61 cases were diagnosed as upper urinary tract urothelial carcinoma by postoperative pathology. The positive cases of UroVysionFISH and urinalysis were 44 cases and 19 cases respectively, the sensitivity was 72.1% and 31.1 %, The difference was statistically significant (P <0.005), the specificity of both were 90%. The sensitivity of UroVysion FISH and urinary cytology to non-myometrial invasion and myometrial invasion were 63.6%, 82.1% and 24.2%, 39.3% respectively. The sensitivity of UroVysionFISH and urinary cytology to the patients with upper urothelial carcinoma of G1, G2 and G3 Sensitivity were 41.2%, 76.2%, 91.3% and 11.8%, 23.8% and 52.2% respectively. Conclusions UroVys-ionFISH provides a rapid, safe and sensitive noninvasive detection method for the early diagnosis and postoperative monitoring of upper urothelial carcinoma in Chinese population.