尿脱落细胞吖啶橙染色检查在膀胱癌诊断中的应用价值

Acridine orange fluorescene in diagnosis of bladder cancer

目的探讨尿脱落细胞吖啶橙荧光染色（AO-F）检查在膀胱癌诊断中的应用价值。方法回顾性分析1016例膀胱癌患者资料，按临床分期、病理分级、肿瘤大小、数目、部位、手术治疗方式及有无血尿症状，分别计算AO-F阳性率，并进行统计学分析。结果1016例患者尿样AO-F阳性率78．05％（793／1016），表浅癌和浸润癌患者阳性率分别为74．69％（611／818）和91．92％（182／198）；病理分级≤Ⅱ级和Ⅲ级患者阳性率分别为67．24％（351／522）和90．37％（413／457）；有无血尿症状患者阳性率分别为80．30％（750／934）和52．44％（43／82）；肿瘤直径≥2cm和〈2cm患者阳性率分别为79．87％（710／889）和65．35％（83／127）；多发和单发肿瘤患者阳性率分别为83．07％（363／437）和74．27％（430／579）；肿瘤累及膀胱三角区或膀胱颈部者阳性率为77．21%（105／136），累及其他部位者为78．07％（687／880）；治疗方法TURBt、膀胱部分切除和膀胱全切除患者阳性率分别为69．68％（393／564），87．87％（268／305）和91．74％（100／109）。AO-F阳性率与膀胱癌临床分期、病理分级、手术治疗方式、肿瘤大小、数目及有无血尿症状等因素有明显相关性，且与其临床分期、病理分级间存在正相关（r值分别为0．99和0．97）；患者性别及肿瘤发生部位等因素与AO-F阳性率之间无相关性。结论尿脱落细胞AO-F检查诊断膀胱癌阳性率高，且简便、无创、经济、准确性高，可反复进行，可提高膀胱癌患者的早期诊断率，值得临床推广应用。

Objective To investigate the diagnostic value of acridine orange fluorescene（AO-F） in bladder cancers. Methods One thousand and sixteen bladder cancer patients were reviewed retro spectively. The positive-rates of AO-F in different stages, grades, size, quantity, position of tumors, hematuria and treatment ways were evaluated. Results The total positive rate of AO-F was 78.05 % （793/1016）. The positive-rate was 74.69% （611/818） in superficial stage and 91.92% （182/198） in invasive bladder cancer, 67.24% （351/522） in grade Ⅰ and Ⅱ , 90.37% （413/457） in grade Ⅲ. The percentage of positive AO-F was 80.30% （750/934） in patients with hematuria, 52.44% （43/82） in patients without hematuria. The percentage was 79.87% （710/889） when the tumor size was more than 2 cm, 65.35% （83/127） when size less than 2 cm. 83.07% （363/437） sample was positive in muhiple tumors, 74. 27% （430/579） in single tumor. The percentage was 77. 21% （105/136） in tumors involving trigone or neck of bladder, 78.07% （687/880） in tumors without involving these regions. There was 69.68% （393/564） in treatment with TURBt, 87.87% （268/305） in partial resection, 91.74% （100/109） in total resection. A good association was observed between stage, grade, hematuria appearance, tumor size, quantity of carcinoma, treatment way and AO-F positive-rate, and a linear correlation was present between grade, stage and positive cytology. There was no significant association between position of the tumor and AO-F positive-rate. Conclusions The function of AO-F is significant in diagnosis of bladder cancer.