荧光原位杂交技术在尿路上皮癌诊断中应用

Application of fluorescence in situ hybridization in Urothelial carcinoma

目的:评估荧光原位杂交技术和液基脱落细胞学在尿路上皮癌诊断中应用价值。方法:收集临床疑为尿路上皮癌的并已有病理诊断结果 121例患者的新鲜尿液标本,同时采用液基脱落细胞学诊断和FISH检测,并采用统计学方法分析其结果及意义。结果:荧光原位杂交技术检测尿路上皮癌的敏感性81.82%(54/66)、特异性100%(55/55)、阳性预测值100%(54/54)、阴性预测值96.49%(55/57)。对于低级别尿路上皮癌FISH的敏感性为68.42%(13/19),而对于高级别尿路上皮癌的敏感性分别87.23%(41/47)。尿液脱落细胞学检测尿路上皮癌的敏感性53.03%(35/66)、特异性92.73%(51/55)、阳性预测值89.74%(35/39)、阴性预测值62.20%(51/82)。对于低级别尿路上皮癌尿液脱落细胞学的敏感性为10.53%(2/19),而对于高级别尿路上皮癌和癌的敏感性分别70.21%(33/47)。联合检测尿路上皮癌的敏感性93.94%(62/66)、特异性100%(55/55)、阳性预测值100%(5/5)、阴性预测值92.73%(51/55)。对于低级别尿路上皮癌联合检测的敏感性为78.95%(15/19),而对于高级别尿路上皮癌和癌的敏感性分别100%%(47/47)。结论:荧光原位杂交技术检测尿路上皮癌的敏感性明显优于尿液脱落细胞学检测,荧光原位杂交技术和尿路脱落细胞学联合诊断敏感性优于单独使用一个诊断方法。

Objective：To evaluate the diagnostic efficiency of urinary cytology and fluorescence in situ hybridization in the diagnosis of urothelial carcinoma. Methods：Fresh urine samples from 121 volunteers who were suspected of suffering from malignant urothelial tumors with pathological diagnosis results were collected,and the specimens were detected by urinary cytology and fluorescence in situ hybridization. Result：When urothelial carcinoma was detected by urinary cytology,the sensitivity was 81.82%（54/66）.The specificity was 100%（55/55）.The positive predictive value was 100%（54/54）.And the negative predictive value was 96.49%（55/57）.While when detecting the low grade tumors,the sensitivity was 68.42%（13/19）.And when detecting the high grade tumors,the sensitivity was 87.23%（41/47）.When detecting urothelial carcinoma by fluorescence in situ hybridization,the sensitivity was 53.03%（35/66）.The specificity was 92.73%（51/55）.The positive predictive value was 89.74%（35/39）.And the negative predictive value was 62.20%（51/82）.While when detecting the low grade tumors,the sensitivity was 10.53%（2/19）.And when detecting the high grade tumors,the sensitivity was 70.21%（33/47）. When detecting urothelial carcinoma by combined diagnosis,the sensitivity was 93.94%（62/66）.The specificity was 100%（55/55）.The positive predictive value was 100%（5/5）.And the negative predictive value was 92.73%（51/55）.When the low grade tumors were detected,the sensitivity was 78.95%（15/19）.And when the high grade tumors were detected,the sensitivity was 100%（47/47）. Conclusion： According to the results, the sensitivity of FISH for the detection of urothelial bladder cancer was superior to that of cytology. The sensitivity of combined diagnosis by urinary cytology and fluorescence in situ hybridization was superior to that of any single method.