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荧光原位杂交技术在膀胱尿路上皮癌诊断及监测中的应用

The utility of fluorescence in situ hybridization for diagnosis and surveillance of bladder urothelial carcinoma.

作者信息

Huang Jian Wen, Mu Jia Gui, Li Yun Wei, Gan Xiu Guo, Song Lu Jie, Gu Bao Jun, Fu Qiang, Xu Yue Min, An Rui Hua

机构信息

Department of Urology, Shanghai Jiao Tong University, Affiliated Sixth People's Hospital, Shanghai, China.

Department of Urology, Harbin Medical University, Affiliated First Hospital, Harbin, China.

出版信息

Urol J. 2014 Nov 30;11(6):1974-9.

Abstract

PURPOSE

To evaluate the clinical value of fluorescence in situ hybridization (FISH) for diagnosis and surveillance of bladder urothelial carcinoma (BUC).

MATERIALS AND METHODS

Between November 2010 and December 2013, patients suspected of having BUC were examined using urine cytology and FISH assay. Based on histopathological examination results, FISH results were com­pared with urine cytology. In addition, patients with a history of non-muscle invasive BUC were also examined using urine cytology and FISH assay at the first time of visit and then monitored with cystoscopy during follow-up period.

RESULTS

A total of 162 patients included in this study and 12 patients were excluded due to uninformative FISH assays. The remaining 150 patients consisted of 108 patients suspected for BUC and 42 patients with a history of non-muscle invasive BUC. The sensitivities of FISH analysis and urine cytology were 72.8% and 27.2%, respectively, and the difference was statistically significant (P <.05). Difference between specificity of urine cytology (100%) and FISH assay (85%) was not statistically significant (P >.05). At the first visit, of 42 patients, one patient had positive cystoscopy, and FISH assay was positive in 26 of 41 patients with negative cystoscopy. During the follow-up period (mean, 29.5 months), 18 of 26 patients developed recurrence, and recurrence occurred in only one of 15 patients with negative FISH analysis.

CONCLUSION

Our results suggest that FISH analysis can be used as a non-invasive diagnostic tool for patients suspect­ed of having new BUC. In addition, FISH analysis may provide important prognostic information to better define the individual risk for BUC recurrence.& nbsp;

摘要

目的

评估荧光原位杂交(FISH)在膀胱尿路上皮癌(BUC)诊断和监测中的临床价值。

材料与方法

2010年11月至2013年12月期间,对疑似患有BUC的患者进行尿液细胞学检查和FISH检测。根据组织病理学检查结果,将FISH结果与尿液细胞学结果进行比较。此外,对有非肌层浸润性BUC病史的患者在首次就诊时也进行尿液细胞学检查和FISH检测,并在随访期间通过膀胱镜检查进行监测。

结果

本研究共纳入162例患者,12例因FISH检测结果不明确而被排除。其余150例患者包括108例疑似BUC患者和42例有非肌层浸润性BUC病史的患者。FISH分析和尿液细胞学检查的敏感性分别为72.8%和27.2%,差异有统计学意义(P <.05)。尿液细胞学检查特异性(100%)与FISH检测特异性(85%)之间的差异无统计学意义(P >.05)。首次就诊时,42例患者中1例膀胱镜检查阳性,41例膀胱镜检查阴性的患者中有26例FISH检测阳性。在随访期间(平均29.5个月),26例患者中有18例复发,FISH分析阴性的15例患者中仅1例复发。

结论

我们的结果表明,FISH分析可作为疑似新发BUC患者的非侵入性诊断工具。此外,FISH分析可能提供重要的预后信息,以更好地确定BUC复发的个体风险。

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