【摘要】：目的比較尿脫落細(xì)胞熒光原位雜交(FISH)檢查、計(jì)算機(jī)斷層掃描(CT)和尿脫落細(xì)胞學(xué)檢查對(duì)以血尿?yàn)橹饕Y狀的上尿路尿路上皮細(xì)胞癌診斷的臨床有效性。方法分析2010年8月至2011年8月可疑上尿路尿路上皮細(xì)胞癌的血尿患者30例,均行FISH檢測(cè)、CT和尿脫落細(xì)胞學(xué)檢查,共有21例經(jīng)病理診斷為上尿路尿路上皮細(xì)胞癌,其中腎盂癌14例,輸尿管癌7例,分期為Ta/T1 6例,T2 12例,T3/T4 3例。另外9例分別為腎盂神經(jīng)內(nèi)分泌癌1例,腎結(jié)核2例,腎透明細(xì)胞癌6例。結(jié)果 FISH檢測(cè)、CT檢查及尿細(xì)胞學(xué)檢查對(duì)上尿路尿路上皮細(xì)胞癌的總敏感性分別為85.7%、66.7%、28.6%,FISH明顯高于CT比較(P=0.014)及尿脫落細(xì)胞學(xué)檢查(P=0.05);CT明顯高于尿脫落細(xì)胞學(xué)檢查(P=0.013)。FISH對(duì)Ta/T1、T2、T3/T4各腫瘤分期檢測(cè)結(jié)果分別為66.7%、91.7%、100%,CT檢查結(jié)果分別為33.3%、75.0%、100%,尿脫落細(xì)胞學(xué)檢查結(jié)果分別為0%、25.0%、100%。FISH、CT及尿脫落細(xì)胞學(xué)診斷上尿路尿路上皮細(xì)胞癌的特異性分別為88.9%、77.8%、100%。三者無統(tǒng)計(jì)學(xué)差異(P0.05)。結(jié)論FISH檢測(cè)上尿路尿路上皮細(xì)胞癌的敏感性明顯高于CT檢查,而CT檢查的敏感性明顯高于尿脫落細(xì)胞學(xué)檢查,并且伴隨著疾病分期的減低,這種差異越明顯。三者在特異性上無明顯差異。FISH技術(shù)可以明顯改進(jìn)上尿路尿路上皮細(xì)胞癌的診斷。
[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.
【作者單位】： 河北省人民醫(yī)院泌尿外科;河北省人民醫(yī)院血液內(nèi)科;
【分類號(hào)】：R737.1

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