CAJ | 학술논문

目的观察浅表性膀胱癌患者尿脱落细胞染色体的核型异常及其与肿瘤复发的关系.方法应用双色荧光原位杂交(FISH)技术分析经随访3年以上病理证实的42例复发和24例未复发浅表性膀胱癌患者尿脱落细胞中7号和17号染色体的拷贝数.绿色和红色荧光素探针分别标记7号和17号染色体.结果 7号、17号染色体异倍体率分别为48.5%(32/66)和50.0%(33/66),两者同时异常表达25.8%(17/66).在G2/3膀胱癌中,复发肿瘤17号染色体异倍体率(64.3%)明显高于未复发肿瘤(22.2%,P＜0.05),而G1膀胱癌中,复发与未复发肿瘤7号、17号染色体异倍体率差异均无统计学意义(均P＞0.05).在pTa和Pt1膀胱癌中,未发现肿瘤复发与7号和17号染色体异常有关,但Pt1膀胱癌中,复发肿瘤7号和17号染色体同时异常表达(47.8%)明显高于未复发肿瘤(12.5%,P＜0.05).在14例复发后进展的膀胱癌中,7号和17号染色体异倍体率(78.6%、92.9%)显著高于未进展膀胱癌(42.9%.46.4%,P＜0.05).结论膀胱癌患者尿脱落细胞染色体的异常有助于判断其术后复发和临床进展.基于FISH技术检测尿脱落细胞有可能成为简便、有效的膀胱癌预后指标之一.
목적 관찰천표성방광암환자뇨탈락세포염색체적핵형이상급기여종류복발적관계.방법 응용쌍색형광원위잡교(FISH)기술분석경수방3년이상병리증실적42례복발화24례미복발천표성방광암환자뇨탈락세포중7호화17호염색체적고패수.록색화홍색형광소탐침분별표기7호화17호염색체.결과 7호、17호염색체이배체솔분별위48.5%(32/66)화50.0%(33/66),량자동시이상표체25.8%(17/66).재G2/3방광암중,복발종류17호염색체이배체솔(64.3%)명현고우미복발종류(22.2%,P＜0.05),이G1방광암중,복발여미복발종류7호、17호염색체이배체솔차이균무통계학의의(균P＞0.05).재pTa화Pt1방광암중,미발현종류복발여7호화17호염색체이상유관,단Pt1방광암중,복발종류7호화17호염색체동시이상표체(47.8%)명현고우미복발종류(12.5%,P＜0.05).재14례복발후진전적방광암중,7호화17호염색체이배체솔(78.6%、92.9%)현저고우미진전방광암(42.9%.46.4%,P＜0.05).결론 방광암환자뇨탈락세포염색체적이상유조우판단기술후복발화림상진전.기우FISH기술검측뇨탈락세포유가능성위간편、유효적방광암예후지표지일.
Objective To analyze the chromosomal karyotype aberrations of exfoliated urothelial cells in superficial bladder cancer patients and the correlation thereof to recurrence of carcinoma.Methods Voided urine samples were collected from 42 patients with pathologically confirmed recurrent bladder cancer and 24 bladder cancer patients without pathologically confirmed recurrence,all of which had undergone complete transurethral resection and had been followed up for more than 3 years.Fluorescence in situ hybridization(FISH)was used with Spectrum Green to label the chromosome 7 and Spectrum Red to label the chromosome 17 of the exfoliated uruthelial cells.Resuits The aneuploidy rates of chromosomes 7 and 17 were 48.5%(32/66)and 50.0%(33/66)respectively,and the co-aneuploidy rate of chromosomes 7 and 17 was 25.8%(17/66).In the patients with G2/3 superficial bladder cancer,the aneuploidy rate of chromosomes 17 of those with recurrence was 64.3%.significantly higher than that of patients without recurrence(22.2%,P＜0.05).However,there were not significant difierences in the aneuploidy rates of chromosomes 7 and 17 in the pTa and pT1 superficial bladder cancer patients with or without recurrence(all P＞0.05).however,the co-aneuploidy rate of chromosomes 7 and 17 of the patients with recurrence was 47.8%,significantly hiher than that of the patients without recurrence(12.5%,P＜0.05).F0urteen of the 42 patients with recurrence showed progression,i.e.,with increased grade or stage(≥pT2).The aneuploidy rates of chromosomes 7 and 17 of these 14 patients were 78.6%and 92.9%respectively.both significantly higher than those of the 28 patients without progression(42.9%and 46.4%respectively,both P＜0.05).Conclusion Abnormality in the chromosomes in exfoliated urothelial cells of superficial bladder cancer patients using FISH technique helps predict recurrence and progression of the cancer.