尿脱落细胞FISH检测方法与CT扫描及尿细胞学检测在上尿路尿路上皮肿瘤诊断中的应用及对比

发布时间：2018-07-22 20:01

【摘要】：目的比较尿脱落细胞荧光原位杂交(FISH)检查、计算机断层扫描(CT)和尿脱落细胞学检查对以血尿为主要症状的上尿路尿路上皮细胞癌诊断的临床有效性。方法分析2010年8月至2011年8月可疑上尿路尿路上皮细胞癌的血尿患者30例,均行FISH检测、CT和尿脱落细胞学检查,共有21例经病理诊断为上尿路尿路上皮细胞癌,其中肾盂癌14例,输尿管癌7例,分期为Ta/T1 6例,T2 12例,T3/T4 3例。另外9例分别为肾盂神经内分泌癌1例,肾结核2例,肾透明细胞癌6例。结果 FISH检测、CT检查及尿细胞学检查对上尿路尿路上皮细胞癌的总敏感性分别为85.7%、66.7%、28.6%,FISH明显高于CT比较(P=0.014)及尿脱落细胞学检查(P=0.05);CT明显高于尿脱落细胞学检查(P=0.013)。FISH对Ta/T1、T2、T3/T4各肿瘤分期检测结果分别为66.7%、91.7%、100%,CT检查结果分别为33.3%、75.0%、100%,尿脱落细胞学检查结果分别为0%、25.0%、100%。FISH、CT及尿脱落细胞学诊断上尿路尿路上皮细胞癌的特异性分别为88.9%、77.8%、100%。三者无统计学差异(P0.05)。结论FISH检测上尿路尿路上皮细胞癌的敏感性明显高于CT检查,而CT检查的敏感性明显高于尿脱落细胞学检查,并且伴随着疾病分期的减低,这种差异越明显。三者在特异性上无明显差异。FISH技术可以明显改进上尿路尿路上皮细胞癌的诊断。
[Abstract]:Objective to compare the clinical efficacy of fluorescence in situ hybridization (fish), computed tomography (CT) and exfoliative cytology in the diagnosis of upper urinary epithelial cell carcinoma with hematuria as the main symptom. Methods from August 2010 to August 2011, 30 patients with suspected upper urinary tract epithelial cell carcinoma (UECC) were examined by fish, CT and exfoliative cytology. A total of 21 cases were pathologically diagnosed as upper urinary epithelial cell carcinoma (UECC). There were 14 cases of renal pelvis carcinoma and 7 cases of ureteral carcinoma. The other 9 cases were renal pelvis neuroendocrine carcinoma (1 case), renal tuberculosis (2 cases) and clear cell carcinoma (6 cases). Results the total sensitivity of fish CT and urine cytology to upper urinary epithelial cell carcinoma was 85.7and 66.7and 28.60.FISH was significantly higher than that of CT (P0. 014) and urine exfoliative cytology (P0. 05). Fish was significantly higher than urinary exfoliative cytology (P0.013). Fish for TaT1T2T3 / T4 was significantly higher than that of CT (P0. 014) and urine cytology (P0. 013). The results of CT examination were 33. 3% and 75. 0%, respectively. The results of urine exfoliation cytology were 0. 025. 0 and 100. The specificity of CT and urine exfoliative cytology in the diagnosis of upper urinary epithelial cell carcinoma was 88.9 / 77.8T and 100, respectively.The specificity of CT and urine exfoliative cytology in the diagnosis of upper urinary epithelial cell carcinoma (UECC) was 88. 9% and 77. 8%, respectively. There was no statistical difference among the three groups (P0.05). Conclusion the sensitivity of fish in the detection of upper urinary tract epithelial cell carcinoma is significantly higher than that of CT, and the sensitivity of CT is significantly higher than that of urine exfoliative cytology. Fish technique can improve the diagnosis of upper urinary tract epithelial cell carcinoma.
【作者单位】：河北省人民医院泌尿外科;河北省人民医院血液内科;
【分类号】：R737.1

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