液基细胞学、DNA倍体及荧光原位杂交对上尿路尿路上皮癌的诊断价值

王富申; 刘秋礼; 杨新; 张军; 张尧; 兰卫华; 王洛夫; 江军

doi:10.16016/j.2097-0927.202202154

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液基细胞学、DNA倍体及荧光原位杂交对上尿路尿路上皮癌的诊断价值

临床医学 | 更新时间：2026-01-09

- 液基细胞学、DNA倍体及荧光原位杂交对上尿路尿路上皮癌的诊断价值
- Diagnostic value of liquid-based cytology, DNA ploidy and fluorescence in situ hybridization in upper tract urothelial carcinoma
- 陆军军医大学学报 2022年44卷第17期页码：1736-1743
- 作者机构：
  
  1.400042 重庆，陆军特色医学中心：泌尿外科
  2.400042 重庆，陆军特色医学中心：病理科
- 作者简介：
  
  [ 江军，E-mail: jiangjun_64@163.com JIANG Jun, E-mail: jiangjun_64@163.com
- 基金信息：
  
  国家自然科学基金面上项目(82172721);陆军军医大学专项研究项目(2018XLC3076);陆军军医大学专项研究项目(2021XQN24)
- DOI：10.16016/j.2097-0927.202202154
  中图分类号： R181.32;R730.43;R737.1
- 收稿：2022-02-25，
  
  修回：2022-04-25，
  
  纸质出版：2022-09-15
- 稿件说明：
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王富申, 刘秋礼, 杨新, 等. 液基细胞学、DNA倍体及荧光原位杂交对上尿路尿路上皮癌的诊断价值[J]. 陆军军医大学学报, 2022,44(17):1736-1743.

Fushen WANG, Qiuli LIU, Xin YANG, et al. Diagnostic value of liquid-based cytology, DNA ploidy and fluorescence in situ hybridization in upper tract urothelial carcinoma[J]. Journal of Army Medical University, 2022, 44(17): 1736-1743.
王富申, 刘秋礼, 杨新, 等. 液基细胞学、DNA倍体及荧光原位杂交对上尿路尿路上皮癌的诊断价值[J]. 陆军军医大学学报, 2022,44(17):1736-1743. DOI： 10.16016/j.2097-0927.202202154.

Fushen WANG, Qiuli LIU, Xin YANG, et al. Diagnostic value of liquid-based cytology, DNA ploidy and fluorescence in situ hybridization in upper tract urothelial carcinoma[J]. Journal of Army Medical University, 2022, 44(17): 1736-1743. DOI： 10.16016/j.2097-0927.202202154.

摘要

目的

探讨液基细胞学、DNA倍体及荧光原位杂交(fluorescence in situ hybridization，FISH)在上尿路尿路上皮癌(upper tract urothelial carcinoma，UTUC)定性诊断中的应用价值。

方法

回顾性分析2013年1月至2021年6月陆军特色医学中心收治的影像可疑UTUC患者246例，经组织病理确诊为UTUC 190例、非肿瘤病变43例、其他类型肿瘤13例；246例均有自然排尿标本的液基细胞学结果，其中178例有DNA倍体分析结果、167例有FISH结果，分别计算并比较液基细胞学、DNA倍体及FISH三者单独或联合对UTUC诊断的准确性。

结果

液基细胞学、DNA倍体及FISH诊断UTUC的敏感性分别为：44.7%、82.2%、57.9%，特异性分别为：97.7%、82.4%、92.3%，对高级别UTUC的诊断敏感性分别为：48.1%、87.7%、60.7%，对低级别UTUC诊断敏感性分别为：25.0%、52.4%、37.5%。三者结合任一阳性时诊断敏感性提升为93.8%(与三者单独比较均

0.05)；当任意两者同时阳性作为诊断UTUC的标准时，其阳性预测值及特异性均为100%。

结论

尿液基细胞学、DNA倍体和FISH对UTUC均有一定诊断价值，三者结合可有效提高诊断的敏感性或特异性。

Abstract

Objective

To investigate the application value of liquid-based cytology

DNA ploidy and fluorescence

in situ

hybridization (FISH) in the diagnosis of upper tract urothelial carcinoma (UTUC).

Methods

From January 2013 to June 2021

246 cases with suspected UTUC on CT or MRI images in the Army Medical Center of PLA were recruited and retrospectively analyzed. Among them

190 cases were pathologically diagnosed as UTUC

43 cases non-tumor lesions

and 13 cases other types of tumors. All the 246 cases were examined with liquid-based cytology of voided urine

178 cases were also with DNA ploidy analysis and 167 cases with FISH. The diagnostic accuracy of liquid-based cytology

DNA ploidy and FISH alone or in combination was calculated and compared.

Results

The sensitivities of liquid-based cytology

DNA ploidy and FISH in the dia

gnosis of UTUC were 44.7%

82.2%

and 57.9%

respectively; the specificities were 97.7%

82.4%

and 92.3%

respectively. The diagnostic sensitivities of the above 3 methods for high-grade UTUC were 48.1%

87.7%

and 60.7%

respectively

and for low-grade UTUC 25.0%

52.4%

and 37.5%

respectively. When any one of the 3 methods is positive

the diagnostic sensitivity was increased to 93.8% (compared with the 3 methods being used alone

all

0.05). When any 2 of them were positive at the same time as the criteria for diagnosing UTUC (both negative or only 1 positive was regarded as negative)

the positive predictive value and specificity of this combined diagnostic method were both 100%.

Conclusion

Urinary liquid-based cytology

DNA ploidy and FISH all are clinically valuable in the diagnosis of UTUC. The combination of the 3 methods can effectively improve the sensitivity or specificity of diagnosis

thereby helping to reduce the risk of missed diagnosis or misdiagnosis.

关键词

Keywords

references

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