Onishi Tetsuro, Ichikawa Tomohiko, Igarashi Tatsuo
Department of Urology, Seirei Citizen Hospital.
Hinyokika Kiyo. 2008 Apr;54(4):253-6.
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.
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。