全自动图象细胞仪在膀胱移行细胞癌尿细胞学诊断中的应用及临床意义

Application of automated image cytometry in urine cythologic diagnosis of transitional cell carcinoma of bladder

目的探讨全自动图像细胞仪对尿脱落细胞DNA异倍体的检测在膀胱肿瘤诊断中的价值及临床意义。方法采用全自动图像细胞仪对40例膀胱移行细胞癌(BTCC)患者和20例良性血尿患者尿样中脱落细胞进行DNA定量分析,同时行常规尿细胞学检查。结果BTCC患者尿液脱落细胞经常规尿细胞学和全自动图像细胞仪检查,阳性率分别为27.5%(11/40)和67.5%(27/40),20例良性血尿患者尿液标本经2种方法检查均为阴性。DNA倍体在膀胱移行细胞癌患者的尿液中为(7.08±2.34)c,在非膀胱移行细胞癌患者的尿液中为(2.95±3.06)c,P<0.01;临床分期Tis^T1为(6.29±3.61)c,T2~T3为(8.55±4.16)c,病理分级Ⅰ级为(5.85±1.72)c,Ⅱ级为(7.24±2.01)c,Ⅲ级为(9.25±1.81)c,DNA含量随着分期分级的增加而增加。结论应用全自动图像细胞仪对BTCC患者尿脱落细胞DNA的定量分析能够反映患者尿细胞中的恶性变化,可以作为BTCC诊断的辅助技术。

Objective To investigate the clinical significance of detecting DNA aneuploid in exfoliated cells of urine specimens with automated imaging cytometry for the diagnosis of transitional cell carcinoma of bladder（BTCC）.Methods 60 volunteers were divided into two groups,i.e,（40 patients with BTCC） and 20 patients with benign haematuria were obtained for the quantitative analysis of DNA content of urine exfoliated cells with automatic imaging cytometry,as wekkas the conventional exanination of urine cytology.Results DNA aneuploid（DI〉2.5 or 5C） was detected in 27 out of 40 urine samples from BTCC group none from the control group of haematuria people.The positive rates of conventional urine Cytology were 16%,lower than that of DNA aneuploid detected with automated image cytometry（P〈0.01,P〉0.05）.DNA content of urine exfoliated cells was（7.0817±2.3432） c in bladder cancer patients and（2.9584±3.0648）c in haematuria patients（P〈0.01）.It was（6.2908±3.6122）c of Tis～T1 and（8.5505±4.1605） c of T2～T4,and（5.8596±1.725） c of G1,（7.2486±2.0176） c of G2,and（9.2558±1.8188） c of G3.With the progress of clinical stage and grade,DNA content of urine exfoliated cells increased（P〈0.05）.Conclusion Automated image cytometry,which uses DNA aneuploid as a marker for tumor,can detect the malignant cells in urine samples of BTCC patients and is a method as a supplementary technique for the diagnosis of BTCC.