尿脱落细胞学检查在原发性输尿管癌诊断中的意义

The Significance of Urinary Cytology in the Diagnosis of Primary Ureter Uroepithelium Cancer

目的:探讨尿脱落细胞学检查(免疫荧光法)阳性率与原发性输尿管癌分级、分期关系。方法:对手术证实原发性输尿管癌的104个病例的临床资料进行回顾性分析,对术前尿脱落细胞学检查阳性率与术后病理分级、分期进行比较并做统计学处理。结果:原发性输尿管癌的尿脱落细胞学检查总阳性率为34.26%,高恶性组的尿脱落细胞学检查总阳性率为43.59%,低恶性组的尿脱落细胞学检查总阳性率为11.54%,其差异有统计学意义x2=8.740,P=0.003。输尿管下段、高恶性的原发癌尿脱落细胞学检查其高分期与低分期的阳性率差异有统计学意义x2=10.628,P=0.001,高恶性的原发性输尿管癌其高分期与低分期的阳性率差异有统计学意义x2=5.678,P=0.017。对于低分期(I～Ⅱ)的原发性输尿管癌高恶性与低恶性的阳性率的差异有统计学意义,x2=12.860,P=0.001。结论:高分级、低分期的原发性输尿管癌尿中更易找到癌细胞,即阳性率更高。

Objective： To research the relationship of urinary cytology positive rate with the grade and stage of primary ureter uroepithelium cancer. Methods： A total of 104 cases of primary ureter uroepithelium cancer were recruited in this study. The urine of all paitents was collected for preoperative urinary cytology detection. The urinary cytology detection rates were compared among different grades and stages of primary ureter uroepithelium cancer. Results： The overall urinary cytology positive rate of primary ureter uroepithelium cancer was 34.26%. The overall urinary cytology positive rate was 43.59% in the advanced stage group and 11.54% in the low stage group, with a significant difference （χ^2=8.740, P=-0.003）. The difference in positive rate between the advanced stage group and the low stage group in the high grade with inferior segment group of primary ureter uroepithelium cancer was statistically significant （χ^2=10.628, P=0.001）. The difference in positive rate between the advanced stage group and the low stage group in the high grade group of primary ureter uroepithelium cancer was statistically significant （χ^2=5.678, P=0.017）. The difference in positive rate between the high grade group and the low grade group in low stage group of primary ureter uroepithelium cancer was statistically significant （χ^2=12.860, P=0.001）. Conclusion： The urinary cytology positive rate of primary ureter uroepithelium cancer of high grade and low stage is higher.