多中心尿路上皮肿瘤克隆起源的FISH研究

The clonal origin of multifocal urothelial carcinoma studied by fluorescence in situ hybridization

目的:探讨多中心尿路上皮肿瘤的克隆起源。方法:通过荧光原位杂交(fluorescence in situ hybrid-ization,FISH)技术对28例患者70枚肿瘤的3、7、9、17号染色体的变异类型进行检测,判断多中心灶间染色体变异类型是否一致。结果:28例患者中,26例(92.9%)被认为来自相同的克隆起源,2例来自不同的克隆起源。2例独立克隆起源的患者均为异时性肿瘤,且原发肿瘤与随后发生的肿瘤间隔时间较久,分别约为5年和11年。结论:大多数多中心尿路上皮肿瘤有相同的克隆起源,为单克隆起源可能,且多为同时性肿瘤。多克隆起源多见于异时性肿瘤,时间间隔越久,独立克隆起源的可能性越大。

Objective：To investigate the clonal origin of multifocal urothelial carcinoma. Method：There were 28 cases of multifocal urothelial carcinoma with total of 70 tumors included in the study. Twenty-one of them were simultaneous urothelial carcinoma and 9 were metachronous. Two cases have both simultaneous tumor and metachronous tumor. Aberration of urothelial carcinoma with high frequency at 3, 7, 9, 17 chromosomes were selected and detected by using CSP3/CSP7 DNA probe combinations and GLP p16/ CSP17 DNA probe combinations. Chromosomal aberrations type was analyzed and compared to determine the clonality of multifocal tumors. Result.. Of the 28 cases, 26 cases（92.9 % ）shared concordant tyPe of chromosomal aberrations, and considered of common clonal origin, 2 cases were detected of discordant type of chromosomal aberrations and were considered independent clonal origin. And both of them were metachronous tumors, and the primary tumor and subsequent tumor had an interval of more than 5 years. Conclusion： Multifocal urothelial carcinomas are mostly of monoclonal origin. Some metachronous tumors are most probably polyclonal origin and always with a long intervals.