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[利用多色荧光原位杂交技术(FISH)诊断尿路上皮癌的研究——FISH与细胞学的对比分析]

[Study on the diagnosis of urothelial cancer using multi-colour fluorescence in situ hybridization (FISH)--comparative analysis between FISH and cytology].

作者信息

Onishi Tetsuro, Ichikawa Tomohiko, Igarashi Tatsuo

机构信息

Department of Urology, Seirei Citizen Hospital.

出版信息

Hinyokika Kiyo. 2008 Apr;54(4):253-6.

Abstract

To determine the diagnostic merit or demerit of genetic procedures using fluorescence in situ hybridization (FISH) for detecting both new and recurrent urothelial cancer, we analyzed the specimens from 81 out-patients with asymptomatic haematuria, aged over 40, in comparison with urine cytology. Of 10 with atypical cytology, 6 showed positive for FISH, and of these, 4 manifested urothelial cancer. FISH showed higher sensitivity in low/intermediate grade cases compared with cytology (FISH; 66.7% vs cytology; 11.1%). Of 15 primary bladder cancer, 4 showed recurrence, and all of these cases showed a positive FISH reaction, but only 1 in cytology. The sensitivity, specificity and accuracy of FISH tests were 81.2, 72.3 and 74.1%, respectively, and these of cytology were 37.5, 98.5 and 86.4% respectively. The FISH test was superior to cytology for sensitivity, but specificity and accuracy were inferior. The FISH tests could be a potent procedure for detecting urothelial cancer in cases of low/intermediate grade, atypical cytology and surveillance setting.

摘要

为了确定使用荧光原位杂交(FISH)检测新发和复发性尿路上皮癌的基因检测方法的诊断优缺点,我们分析了81例40岁以上无症状血尿门诊患者的样本,并与尿液细胞学检查结果进行比较。在10例非典型细胞学检查结果的患者中,6例FISH检测呈阳性,其中4例确诊为尿路上皮癌。与细胞学检查相比,FISH在低/中级病例中显示出更高的敏感性(FISH;66.7% 对比细胞学;11.1%)。在15例原发性膀胱癌患者中,4例出现复发,所有这些病例FISH检测均呈阳性反应,但细胞学检查仅1例呈阳性。FISH检测的敏感性、特异性和准确性分别为81.2%、72.3%和74.1%,而细胞学检查的相应数值分别为37.5%、98.5%和86.4%。FISH检测在敏感性方面优于细胞学检查,但在特异性和准确性方面较差。FISH检测可能是检测低/中级、非典型细胞学病例及监测环境中尿路上皮癌的有效方法。

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