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目的 研究微卫星分析在膀胱癌诊断中的应用价值 ,并比较该方法与尿细胞学的优缺点。方法 利用前续工作建立的 9位点的诊断组合和新筛选的 4个微卫星位点 ,对 1 43例膀胱病变和非膀胱病变个体的尿沉渣进行盲性分析 ,同时进行尿细胞学检查 ,比较二者的结果。结果 89%(97/1 0 9)的膀胱癌 ,86% (6/7)的膀胱内翻性乳头状瘤 ,3例膀胱炎 (共检测 7例 )和 1例不明原因血尿的病人的尿沉渣至少在 1 3个位点中的一个检测出异常 ,1 9例非膀胱病变病人的尿沉渣未检测到任何异常。检测到尿沉渣微卫星异常的 3例膀胱炎和 1例不明原因血尿的病人 ,其细胞学也提示核异型或可疑癌细胞。在同时进行了尿沉渣微卫星分析和细胞学检查的 81例膀胱癌中 ,细胞学检出率为51 % (4 1 /81 ) ,而且主要集中于中晚期病人 ,微卫星分析的检出率为 90 % (73 /81 ) ,与分期分级无关。 1 2例微卫星分析阴性的膀胱癌病人中 ,有 4例细胞学发现癌细胞。结论 尿沉渣微卫星分析对于膀胱癌的诊断有一定意义。尿沉渣微卫星分析与传统尿细胞学有一定互补作用。
Objective To study the value of microsatellite analysis in the diagnosis of bladder cancer and to compare the advantages and disadvantages of this method with urinary cytology. Methods A total of 9 microsatellite loci established in the previous work were used to analyze the urinary sediment in 143 individuals with bladder lesions and non-bladder lesions. Urinary cytology was performed at the same time. Compare the results of both. Results 89% (97/1 0 9) of bladder cancer, 86% (6/7) of the bladder papilloma, 3 cases of cystitis (a total of 7 cases) and 1 case of urinary tract urinary tract unexplained urine Abnormality was detected in at least one of the 13 sites in the sediment, and no abnormality was detected in urinary sediment in 19 non-bladder patients. Three cases of cystitis and one case of unknown hematuria who detected microscopic anomalies of urinary sediment also showed cytogenetics or suspicious cancer cells in their cytology. Among the 81 cases of bladder cancer with microsatellite analysis and cytology of urinary sediment, the cytological detection rate was 51% (4 1/81), and mainly concentrated in the patients with advanced stage, the detection rate of microsatellite analysis 90% (73/81), regardless of staging. In 12 cases of microsatellite-negative bladder cancer patients, 4 cases of cytology found cancer cells. Conclusion Urinary sediment microsatellite analysis for the diagnosis of bladder cancer has some significance. Urinary sediment microsatellite analysis with traditional urinary cytology have a certain complementarity.