膀胱癌荧光原位杂交检测及其临床意义

Clinical Significance of Detection by Fluorescence in Situ Hybridization for Bladder Cancer

目的:分析膀胱移行细胞癌的染色体畸变情况,探讨荧光原位杂交(FISH)技术在膀胱癌的临床应用价值。方法:采用3、7、17号染色体着丝粒探针和9号染色体p16基因位点探针对56例膀胱移行细胞癌患者和20名健康人群的新鲜尿液进行FISH检测,统计染色体的畸变并分析其与病理分级、分期的关系。对所有病例同步进行尿细胞学分析。结果:膀胱癌患者尿脱落细胞核中3、7、17号染色体及9号染色体p16基因畸变率分别为58.9%、39.3%、58.9%和75.0%,各染色体畸变在膀胱癌不同分期之间的差异无统计学意义(P>0.05),3、7、17号染色体畸变在不同分级之间的差异具有统计学意义(P<0.05),四染色体探针组合诊断膀胱癌的总阳性率为80.4%;膀胱癌尿脱落细胞的FISH检出率明显高于尿细胞形态学。结论:膀胱癌的发生发展与染色体的畸变有关,膀胱癌尿脱落细胞的FISH检测,对膀胱癌的早期诊断、预后评估及复发监测等具有重要价值。

Objective： To analyze chromosome aberrations in bladder transitional cell carcinoma with exfoliated cells, and to evaluate the clinical value of fluorescence in situ hybridization （FISH） in bladder cancer. Methods： FISH was performed using centromeric probes of 3, 7, 17 and locus probe of p16 to examine chromosome aberrations of exfoliated cells of 56 bladder cancer patients and 20 healthy controls to analyze the correlation of chromosome aberration with the pathological features of bladder cancer. The urine cytology of the 56 bladder cancer patients was performed. Results： The rates of aneuploidy of chromosomes 3, 7, and 17 were 58.9%, 39.3%, 58.9% and 75.0% for aberration of p16 in exfoliated cells from the 56 bladder cancer patients. All of the aberrations had no correlation with tumor stage （P〉0.05）. The aberrations of chromosomes 3, 7, and 17 were significantly correlated with pathological grade （P〈0.05）. The sensitivity of the 4 chromosome probes for detecting bladder cancer was 80.4%. The detection rate of FISH was obviously higher than that of urine cytology. Conclusion： Chromosome aberration is correlated with the growth of bladder cancer. The detection of FiSH has significance for early diagnosis, prognosis evaluation, and recurrence monitoring of bladder cancer.