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1、荧光原位杂交检测尿脱落细胞染色体异常诊断膀胱肿瘤的研究王鹏，靳风烁，叶锦，吴刚，李彦锋，张尧，梁平（第三军医大学大坪医院野战外科研究所泌尿外科，重庆400042）摘要：目的本研究旨在探讨通过荧光原位杂交（Fluorescenceinsituhybridization，FISH)检测3、7、9、17号染色体数目畸变诊断国人膀胱尿路上皮癌的可行性和有效性。方法采用3、7、17号染色体着丝粒探针和9p21区带探针对140例观察者尿液脱落细胞核行荧光原位杂交，并同时行经腹部超声和尿脱落细胞学检查，以膀胱镜病理检查确诊，比较分析各种方法的敏感性和特异性。结
2、果⑴肿瘤组80例膀胱尿路上皮癌全部经病理检查确诊，其中68例FISH结果阳性，26例尿脱落细胞学阳性，71例经腹部超声诊断为膀胱癌。⑵非肿瘤对照组30例，其中29例FISH结果阴性，1例假阳性；尿脱落细胞学检查全部阴性；经腹超声检查23例阴性，7例假阳性。FISH、尿脱落细胞学、经腹部超声的灵敏度分别为85.00%、32.50%、88.75%，特异度分别为96.67%、100.00%、76.67%。结论使用FISH技术检测尿脱落细胞3、7、9、17号染色体数目畸变，具有敏感度高、特异性强的优点，并具无创性，对国人膀胱尿路上皮癌的诊断具有重要的临床
3、应用价值。关键词：膀胱肿瘤；原位杂交；诊断中图法分类号：R737.14文献标识码：AThestudyonurineexfoliatedcellchromosomeaberrationdetectedbyfluorescenceinsituhybridizationofthebladderWangPeng,JinFeng-shuoYeJin,WuGang,LiYan-feng,ZhangYao,LiangPing(DepartmentofUrology,TheThirdAffiliatedHospitalofThirdMilitaryMedicia
4、lUniversity,Chongqing400042,China)Abstract：ObjectiveTheaimofthisstudywastoevaluatethepossibilityandvalidityofdetectingnumericalaberrationofchromosome3,7,9,17byfluorescenceinsituhybridization(FISH)indetectingurothelialcarcinomaofbladderinChinese.Mehtods140volunteerswererecruit
5、edassubjects.ExfoliatedcellsfromfreshurinaryspecimenwascollectedandthecellwasexaminedbyFISHusingcentromericprobesofchromosome3,7,17andregionprobeof9p21.Cytologyandtransabdominalultrasonography(US)wasappliedatthesametimeandallofthepatientsweredefinitelydiagnosedbycystoscopyand
6、biopsy.Thesensitivityandspecificityofeachmethodinthediagnosisofbladdercancerweredeterminedbycomparativeanalysis.Results⑴Tumorgroup:Thesubjectsinclude80patientswithurothelialcarcinomadefinitelydiagnosedbypathology.68patientsshowpositivebyFISH,28arepositivebyurinecytology,and71
7、arepositivebyUS.⑵Innon-tumorcontrolgroupof30cases,29shownegativeand1false-positivebyFISH,30negativebyurinecytology,23negativeand7false-positivebyUS.ThesensitivityandspecificityofFISH，urinecytologyandUSondetectingbladdercancerwere85.00%,32.50%,88.75%,and96.67%,100.00%,76.67%,r
8、espectively.ConclusionThesensitivityandspecificityofFISHdetecting3，7
