多靶位荧光原位杂交技术对上尿路尿路上皮癌诊断的应用价值

Application value of multi-target fluorescence in situ hybridization in patients with upper urinary tract urothelial carcinoma

目的:比较多靶位荧光原位杂交技术(M-FISH)、尿脱落细胞学对上尿路尿路上皮细胞癌(UTUC诊断的临床研究。方法:30例正常健康人通过FISH检测3、7、l7号染色体非整倍性及9号染色体p16位点缺失等变异情况,确立阈值。同时收集101例影像学初步怀疑UTUC患者的尿液标本,行FISH检测和尿脱落细胞学检查,以手术病理结果为金标准,比较FISH、尿脱落细胞学检查对UTUC诊断的敏感度及特异度。结果:FISH、尿脱落细胞学检查对UTUC诊断的敏感度分别为78.9%(71/90)和38.9%(35/90),差异有统计学意义(P<0.05);特异度为90.9%(10/11)和90.9%(10/11),差异无统计学意义(P>0.05)。结论:与尿脱落细胞学检查相比,FISH对UTUC诊断有更高的敏感度和相似的特异度,是对UTUC进行早期无创伤性诊断的有效手段。

Objective:To compare between multi-target fluorescence in situ hybridization(FISH)and urinary cytology on the diagnosis of upper urinary tract urothelial carcinoma(UTUC).Method:Thirty healthy people were detected by FISH to detect the variation of chromosome 3,7 and 17 aneuploidy and the deletion of p16 site on chromosome 9.At the same time,urine samples from 101 patients with UTUC initially suspected by imaging were collected.FISH and urine cytology were performed at the same time.The pathological results were taken as the gold standard.The sensitivity and specificity between FISH and urine cytology to UTUC were compared.Result:The sensitivity of FISH and urine cytology to the diagnosis of UTUC were 78.9%(71/90)and 38.9%(35/90)respectively,and the difference was statistically significant(P<0.05).The specificity were 90.9%(10/11)and 90.9%(10/11)respectively,and the difference was not statistically significant(P >0.05).Conclusion:Compared with urinary cytology,FISH has higher sensitivity and similar specificity for the diagnosis of UTUC,so it's an effective method for early diagnosis of UTUC.