膀胱移行细胞癌术后复发与染色体畸变的相关性研究

摘要

目的 探讨膀胱移行细胞癌(TCCB)术后复发与染色体畸变的相关性及其临床意义.方法 35例TCCB组织(复发19例、未复发16例)采用荧光原位杂交技术(FISH)检测,观察其3、7、17号染色体及9号染色体p16基因的畸变情况.另选10例癌旁正常组织为对照.结果 19例复发性TCCB组织中,3、7、17号染色体及9号染色体p16基因的畸变率分别为42.11％、57.89％、84.21％和89.47％；在16例未复发性TCCB中分别为31.25％、37.50％、43.75％和50.00％.17号染色体和9号染色体p16基因位点的畸变率TCCB复发者明显高于未复发者(P均＜0.05),其畸变与TCCB复发呈正相关(r分别为0.391和0.399,P均＜0.05)；在复发性TCCB的G1级与G2-3级组织中7号染色体异常差异有统计学意义(P＜0.05),其畸变与TCCB组织分级呈正相关(r为0.565,P＜0.05)；各染色体异常与TCCB病理分期、复发次数均无相关性(P均＞0.05).结论 TCCB术后复发与9号染色体p16基因及17号染色体畸变呈正相关,复发性TCCB中7号染色体畸变与TCCB组织分级呈正相关.TCCB患者术后定期随访并行FISH监测,对于及早发现病变并及时治疗具有重要临床意义.%Objective To investigate the relevance and clinical significance of the postoperative recurrence and chromosomal aberrations in the transitional cell carcinoma of bladder ( TCCB ) . Methods Fluorescence in situ hybridization was used to detect the chromosome aberrations of 3,7 and 17 and 9 pl6 gene in 35 cases patients of transitional cell carcinoma of bladder,including 19 cases patients who were recurrence and 16 cases who were non-recurrence. Ten cases of adjacent normal tissue were chosen as control. Results The rate of chromosome 3,7,17 and 9 pl6 aberration in 19 cases of recurrent TCCB tissues were 42. 11%, 57. 89% , 84.21% and 89.47%. Rate in 16 cases of non-recurrence TCCB tissues were 31. 25% , 37.50% , 43.75% and 50.00%. The rate of chromosomes 17 and 9pl6 aberration in the recurrence TCCB tissues were obviously higher than the non-recurrence (all P < 0.05). The aberration and recurrence showed a positive correlation (r were 0.391 and 0.399 respectively, all P<0.05). There were significant difference between G, and G2_3 levels in chromosome 7 of recurrence TCCB tissues (P <0.05). The aberration and recurrence showed a positive correlation( r was 0.565 ,P < 0.05). The chromosomes changes above were not associated with pathological stage or the numbers of recurrences (all P>0.05). Conclusions There was positive correlation between the postoperative recurrence of transitional cell carcinoma of bladder and chromosome aberrations of chromosome 9 pl6 gene and chromosome 17. In the recurrent TCCB , there was a positive correlation between the aberration of chromosome 7 and histologic grade. Monitoring FISH regularly for the postoperative TCCB patients has important clinical significance for the early detection of disease and treatment in time.