Fornari Delfina, Steven Kenneth, Hansen Alastair B, Vibits Henrik, Jepsen Jan V, Poulsen Asger L, Schwartz Marianne, Horn Thomas
Department of Pathology, Herlev University Hospital of Copenhagen, Denmark.
APMIS. 2004 Feb;112(2):148-52. doi: 10.1111/j.1600-0463.2004.apm1120210.x.
The aim was to evaluate microsatellite analysis of urine sediment (MAUS) as an alternative method to urine cytology for routine diagnosis of patients with transitional cell tumors (TCT) of the urinary bladder. Urine cytology has the advantage of being non-invasive, fast and cheap, but is of limited value because of its low sensitivity. MAUS has previously been found to be a successful alternative method. However, the experimental set-up of such investigations implied exclusion of samples with unfavorable characteristics and use of a large number of markers. In the present study, MAUS was tested on all samples routinely available and a small panel of markers was selected. The urine sediments of 66 TCT patients and 24 controls were analyzed by MAUS with 16 fluorescent markers and by urine cytology. All samples were analyzed, including the ones of later micturition, with gross hematuria, leukocyturia or absence of visible sediment. In patients with tumors of low grade (grades I-II), MAUS was significantly more sensitive than urine cytology. The two methods were of equivalent diagnostic power in high-grade (grades III-IV), high-stage (pT1-pT4) tumors. A panel of the six most informative markers for MAUS was selected. Although MAUS has an advantage over routine cytology in low-grade, low-stage tumors, an overall sensitivity of 45% is not sufficient for routine clinical use.
目的是评估尿沉渣微卫星分析（MAUS）作为膀胱移行细胞肿瘤（TCT）患者常规诊断中尿细胞学替代方法的可行性。尿细胞学具有非侵入性、快速且廉价的优点，但由于其低敏感性，价值有限。此前已发现MAUS是一种成功的替代方法。然而，此类研究的实验设置意味着排除具有不利特征的样本并使用大量标记物。在本研究中，对所有常规可得的样本进行MAUS检测，并选择了一小部分标记物。使用16种荧光标记物通过MAUS和尿细胞学对66例TCT患者及24例对照的尿沉渣进行分析。分析了所有样本，包括排尿后期、伴有肉眼血尿、白细胞尿或无可见沉渣的样本。在低级别（I-II级）肿瘤患者中，MAUS的敏感性显著高于尿细胞学。在高级别（III-IV级）、高分期（pT1-pT4）肿瘤中，两种方法的诊断能力相当。选择了一组对MAUS最具信息量的六种标记物。尽管MAUS在低级别、低分期肿瘤中优于常规细胞学，但45%的总体敏感性对于常规临床应用而言并不足够。
