荧光原位杂交应用于尿路上皮癌尿液早期诊断的研究进展

摘要

Urothelial carcinoma is one of the most common urinary malignant tumors. Early diagnosis is important for its treatment. FISH diagnoses UC by urine, which is a fast, no traumatic, and high sensitivity and specificity. This article reviews the clinical application research reports about fish in bladder UC, upper urinary tract UC and monitoring after transurethral resection of bladder tumor. Authors make some conclusions, Fish increases the sensitivity and specificity of urinary cytology in lower grade or superficial bladder UC and decreases false positive caused by hematuria, urinary tract infection and perfusion bladder. FISH has higher the sensitivity and specificity in upper urinary tract UC. The loss of p16 anti-oncogene in 9 chromosome is related to recurrence of the bladder UC. FISH not only predict the recurrence but also monitor the recurrence, and it needs large and multicenter prospective study.%尿路上皮癌(urothelial carcinoma,UC)是泌尿系统最常见恶性肿瘤之一,早期诊断是提高该类疾病疗效的关键所在,荧光原位杂交(fluorescence in situ hybrization,FISH)通过尿液来检测UC,具有快速、无创伤性、敏感度高和特异性强等优点.FISH提高了尿细胞学在低级别或浅表性膀胱UC诊断的敏感性,且减少了血尿、尿路感染及膀胱内灌注治疗等对细胞形态的影响而引起的假阳性,提高检测的特异性.对于诊断上尿路UC,FISH的敏感性与特异性更高.膀胱UC患者9号染色体p16抑癌基因丢失与复发明显相关,FISH既能预测膀胱UC的复发性,更能监测UC的复发,但仍需大样本、多中心的前瞻性研究.本文将FISH在膀胱UC、上尿路 UC早期诊断以及膀胱UC术后监测等方面的临床应用研究报道进行综述.