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目的分析比较荧光原位杂交技术(FISH)与尿液脱落细胞学在膀胱尿路上皮肿瘤检测中灵敏性与特异性的差异。方法 2007年6月至2008年12月,收取20例健康人群的新鲜尿液,应用荧光标记的3号、7号、17号染色体着丝粒探针及p16位点探针,对尿液脱落细胞进行FISH检测,建立正常人群的阈值;留取临床确诊的93例膀胱上皮肿瘤患者的尿液标本,同时进行尿液脱落细胞学检查及FISH检测,对比尿液脱落细胞学检查及FISH检测结果,对FISH、尿液脱落细胞学检查检测膀胱尿路上皮癌的敏感性和特异性进行统计学分析。结果 FISH、尿液脱落细胞学检测膀胱尿路上皮癌总的敏感性分别为90.78%%(69/76)和48.10%%(38/79),P<0.01,特异性分别为82.35%(13/17)、92.85%(13/14),P>0.05。FISH检测膀胱尿路上皮癌的敏感性优于尿液脱落细胞学检查,而两者在特异性方面无统计学意义。结论 FISH技术可以提高膀胱尿路上皮肿瘤的诊断率,优于尿液脱落细胞学检查,是膀胱尿路上皮肿瘤筛查中新的无创性的检查方法。
Objective To compare the sensitivity and specificity of fluorescence in situ hybridization (FISH) and urine exfoliative cytology in the detection of bladder urothelial carcinoma. Methods From June 2007 to December 2008, 20 fresh urine samples from healthy people were collected. Fluorescently labeled centromeric probes Nos. 3, 7, 17 and p16 probe were used to detect the urine excretion FISH detection of the cells to establish the normal population threshold; to retain the clinically diagnosed 93 cases of bladder epithelial tumor in urine samples, urine cytology and FISH detection, urine exfoliation cytology and FISH test results . The sensitivity and specificity of FISH and urinary exfoliative cytology in the detection of bladder urothelial carcinoma were statistically analyzed. Results The overall sensitivity of FISH and urinary excretion cytology in detecting bladder urothelial carcinoma were 90.78% (69/76) and 48.10% (38/79) respectively, with P <0.01 and specificity of 82.35% (13 /17),92.85%(13/14),P>0.05. FISH detection of urinary bladder cancer urinary bladder cancer is more sensitive than exfoliative cytology, but the specificity of the two was not statistically significant. Conclusion FISH can improve the diagnostic rate of bladder urothelial tumors, which is better than urine cytology. It is a new noninvasive method for bladder urothelial cancer screening.