GLPp16/CSP17 探针在膀胱尿路上皮癌诊断中的应用

目的:探讨荧光原位杂交技术辅助诊断膀胱尿路上皮癌的可行性。方法:标记为17号染色体着丝粒及9号染色体p16位点9p21区带探针,采用荧光原位杂交技术(Fluorescence in Situ Hybridization FISH)对80例膀胱肿瘤患者尿液间期细胞核进行荧光原位杂交,以20例健康志愿者作为正常对照组,建立阈值。以术后病理结果作为诊断"金标准",对80例膀胱肿瘤患者同时行尿脱落细胞学检查,与FISH进行比较。结果:17号染色体和9p21的畸变率分别为57.5%和63.8%。17号染色体畸变率主要表现为多倍体,与膀胱癌的分级有显著相关性(P<0.01);9号染色体畸变率主要变现为染色体缺失,与膀胱癌分期分级均无相关性(P>0.05)。尿脱落细胞学灵敏度为12.2%,FTSH技术灵敏度为86.5%;两者差异有统计学意义(P<0.01)。结论:荧光原位杂交技术可以作为膀胱尿路上皮癌诊断的一项重要方法,并可能在预后判断中具有重要临床意义。

Application of GLPp16/CSP17 probe in the Diagnosis of Bladder Urothelial Carcinoma

Objective: To evaluate the possibility of Fluorescence in Situ Hybridization(FISH) in detecting Urothelial carcinoma of the urinary bladder.Methods: The probes of chromosome 17centromeres and chromosome 9 9p21 region(p16) were labeled by random primer method.FISH was performed on interphase nuclei of 80 urine specimens of suspected bladder urothelial carcinoma,all the urine specimens were analyzed by urinary cytology at the same time.The pathological diagnosis was the "Golden standard",to analyse the sensitivity and specificity of FISH and urinary cytology to diagnose bladder urothelial cancinoma.20 normal donors were analyzed to establish threshold value.Results: The rate of aberration was 57.5%for chromosome 17 and 63.8% for chromosome 9p21 in urothelial carcinoma of the urinary bladder.All the aberrations had no correlation to tumor stage(P>0.05),the aberration of chromosome 17 was correlated to pathologic grade significantly(P<0.01).The specificity was 100% with FISH and 100% with cytology,although this difference was not statistically significant(P>0.05).We found a significant difference between the sensitivity of FISH and cytology(86.5% vs.12.2%,respectively;P<0.01).Conclusion: FISH was proved to be a very important method in diagnosis and prognosis.of Urothelial cancinoma of the urinary bladder.