尿脱落细胞微卫星DNA改变在膀胱癌早期诊断中的应用

Application of microsatellite alteration of urine sediment in the early diagnosis of bladder cancer

目的 利用检测尿脱落细胞微卫星DNA序列 (microsatellite ,MS)改变 ,建立早期诊断膀胱癌的方法。方法 选择 10对微卫星MS引物 ,利用聚合酶链反应 (PCR)方法 ,以自身外周血和膀胱癌组织为对照 ,检测 2 8例膀胱癌患者尿脱落细胞中MS的失杂合 (lossofheterozygosity,LOH)和不稳定性 (microsatelliteinstability ,MIN)。结果 2 8例膀胱癌患者中 ,2 4例 (85 .7% )尿脱落细胞至少在 1个MS位点存在LOH或MIN改变 ,3例 (10 .7% )脱落细胞学检查阳性患者尿脱落细胞均检出LOH或MIN。同一患者尿脱落细胞与癌组织LOH改变一致率为 94.1%。 15例正常人尿脱落细胞中未见MS的改变。结论 利用检测尿脱落细胞MS改变诊断膀胱癌 ,比常规的细胞学检查更敏感、更准确、更特异 ,可作为临床上筛查。

Objective To assess the usefulness of microsatellite DNA sequence (MS) alterations in urine sediment for early diagnosis of human bladder cancer.Methods Loss of heterozygosity(LOH) and microsatellite instability(MIN) in urine sediment from 28 cases of bladder cancer were detected by polymerase chain reaction(PCR) with selected primers of 10 microsatellite loci. The peripheral blood mononuclear cells and bladder carcinoma cells were used as controls.Results In 24 of 28 bladder cancer patients (85.7%) LOH and MIN were found in urine sediment on at least one MS locus. Only in 3 of 28 patients(10.7%) was the urine cytology positive while MS and MIN were detected in these 3 patients. The conformance of MS alterations between cancer cells and urine sediment in the same patients was 94.1%. No MS alteration was found in 15 normal controls.Conclusion Application of microsatellite sequence of urine sediment can be considered as a new tool for screening and early diagnoses of bladder cancer.