Têtu B, Katz R L, Kalter S P, Von Eschenbach A C, Barlogie B
Department of Pathology, University of Texas, M. D. Anderson Hospital and Tumor Institute, Houston.
Semin Diagn Pathol. 1987 Aug;4(3):243-50.
A review of acridine-orange DNA and RNA flow cytometry (FCM) histograms of 249 bladder irrigation specimens from 129 patients with a previous history of transitional cell carcinoma (TCC) reveals that aneuploidy and tetraploidy (greater than 10% of total cell population) are reliable markers to detect the presence of bladder tumor in patients treated by surgical resection of tumor only. Tetraploidy is unreliable when the patient received intravesical chemotherapy or radiation therapy but aneuploidy remains accurate. A comparison of the reliability of FCM compared with cytology indicates an overall lower sensitivity and specificity for FCM (respectively, 52% and 73%) as opposed to cytology (respectively, 62% and 92%). Sensitivity is improved and raised to 77% if FCM and cytology are used in conjunction and reaches 82% in patients treated by surgery only and 88% in those who received radiation therapy. The lowest sensitivity and specificity obtained with FCM are in patients treated by intravesical chemotherapy (respectively, 44% and 58%) and the highest are in those treated by surgery without additional therapy (56% and 83%). This study demonstrates that FCM criteria for diagnosis of TCC of urinary bladder on bladder irrigation specimens depends on patient's treatment history. It also indicates that sensitivity and specificity of cytology to detect bladder tumor are superior to those obtained with FCM but both methods may be considerably improved if they are used in conjunction.
对129例既往有移行细胞癌（TCC）病史患者的249份膀胱冲洗标本的吖啶橙DNA和RNA流式细胞术（FCM）直方图进行回顾分析，结果显示，非整倍体和四倍体（占总细胞群的10%以上）是仅接受肿瘤手术切除患者检测膀胱肿瘤存在的可靠标志物。当患者接受膀胱内化疗或放射治疗时，四倍体不可靠，但非整倍体仍然准确。FCM与细胞学可靠性的比较表明，FCM的总体敏感性和特异性较低（分别为52%和73%），而细胞学（分别为62%和92%）则相反。如果联合使用FCM和细胞学，敏感性可提高到77%；仅接受手术治疗的患者中敏感性达到82%，接受放射治疗的患者中敏感性达到88%。FCM获得的最低敏感性和特异性出现在接受膀胱内化疗的患者中（分别为44%和58%），最高则出现在未接受额外治疗的手术患者中（56%和83%）。本研究表明，膀胱冲洗标本上诊断膀胱TCC的FCM标准取决于患者的治疗史。研究还表明，细胞学检测膀胱肿瘤的敏感性和特异性优于FCM，但如果联合使用，两种方法均可得到显著改善。
