尿液無創(chuàng)聯(lián)合檢測在膀胱癌早期診斷中的意義
發(fā)布時間：2018-09-03 11:57
【摘要】：目的討論尿脫落細(xì)胞吖啶橙染色法(AO-F)、熒光原位雜交染色(FISH)以及膀胱腫瘤抗原(BTA)單獨或聯(lián)合檢測在膀胱尿路上皮癌診斷中的意義。為早期無創(chuàng)診斷膀胱癌提供理論依據(jù)。方法1.收集2016年3月-2016年11月就診于天津醫(yī)科大學(xué)第二醫(yī)院泌尿外科的膀胱患者82名。泌尿系統(tǒng)良性疾病患者27名納入對照組。2.收集患者尿液樣本并對其分組編號。分別對這些尿液樣本進(jìn)行尿脫落細(xì)胞吖啶橙染色法(AO-F)檢測、膀胱腫瘤抗原(BTA)檢測及熒光原位雜交(FISH)檢測。3.分析AO-F、FISH、BTA單獨檢測在膀胱癌中的診斷意義及病理分級和分期的相關(guān)性。4.討論三種檢查手段聯(lián)合檢測在膀胱癌診斷中的意義,包括串聯(lián)檢測和并聯(lián)檢測,使用SPSS18.0繪制受試者工作曲線(ROC),通過曲線下面積(AUROC)對比各種組合在膀胱癌檢測中的診斷價值。結(jié)果1.AO-F、BTA、FISH三種方法單獨檢查膀胱癌,敏感性依次為62.2%、69.5%、74.4%,特異性分別為92.6%、77.8%、89.9%。其中FISH敏感性最高,AO-F特異性最高。分析三種檢查方法的曲線下面積(AUROC),三者分別為0.774,0.736和0.816,差異有統(tǒng)計學(xué)意義,可見FISH的診斷價值最大。2.在低分期和分級的腫瘤中,AO-F的敏感性明顯低于高分期和高級別的腫瘤,差異有統(tǒng)計學(xué)意義。3.通過對三種方法聯(lián)合檢測膀胱癌的結(jié)果分析,將聯(lián)合檢測分為串聯(lián)和并聯(lián)兩種情況:聯(lián)合檢查中,各項檢查結(jié)果同時陽性判定總的結(jié)果陽性既為串聯(lián),聯(lián)合檢查中若至少有一種檢測陽性則判定總的結(jié)果陽性即為并聯(lián)。各種串聯(lián)組合的特異性均為100%,所有串聯(lián)檢查中,BTA串聯(lián)FISH檢查為敏感性最高的組合,達(dá)73.2%,根據(jù)計算AUROC,可見AO-F并聯(lián)FISH檢查對膀胱癌的診斷價值最大。結(jié)論1.本實驗?zāi)蛞簶?biāo)本易收集,可行性高2.AO-F、BTA、FISH檢查對膀胱癌的診斷具有臨床意義。3.以上三種檢查單獨檢測膀胱癌時,FISH的診斷價值最大。4.AO-F檢查敏感性與腫瘤的臨床分期和病理分級呈正相關(guān)。5.在以上三種檢查方法聯(lián)合檢查的各種組合中,AO-F并聯(lián)FISH檢查對膀胱癌的診斷價值最大,故建議對就診患者行AO-F和FISH檢查,能夠降低膀胱鏡檢查的使用頻率。
[Abstract]:Objective to evaluate the diagnostic value of acridine orange staining (AO-F), fluorescence in situ hybridization (Fish) and bladder tumor antigen (BTA) in the diagnosis of bladder epithelial carcinoma. To provide theoretical basis for early non-invasive diagnosis of bladder cancer. Method 1. A total of 82 urinary bladder patients from March 2016 to November 2016 in the second Hospital of Tianjin Medical University were collected. 27 patients with benign urinary system diseases were included in the control group. 2. 2. Collect urine samples from patients and group them. The urine samples were detected by acridine orange staining (AO-F), bladder tumor antigen (BTA) and fluorescence in situ hybridization (FISH). To analyze the diagnostic significance of AO-F,FISH,BTA alone in bladder cancer and the correlation between pathological grade and stage. 4. This paper discusses the significance of combined detection of three methods in the diagnosis of bladder cancer, including series detection and parallel detection. The diagnostic value of (ROC), in bladder cancer detection is compared by using SPSS18.0 to draw the operating curve of subjects by area (AUROC) under the curve. Results 1.The sensitivity of AO-FTA-FISH alone was 62.2 and 69.5%, and the specificity was 92.6 and 77.8% respectively. The sensitivity of FISH was the highest and the specificity of AO-F was the highest. The area under the curve of the three methods was 0.7740.736 and 0.816, respectively. The difference was statistically significant, showing that the diagnostic value of FISH was the greatest. 2. The sensitivity of AO-F in low-grade and low-grade tumors was significantly lower than that in high-grade and high-grade tumors, and the difference was statistically significant. Through the analysis of the results of combined detection of bladder cancer by three methods, the combined detection was divided into series and parallel cases: in the joint examination, the positive results were determined to be in series at the same time. If there is at least one positive test in the joint examination, the total positive result is determined to be parallel. The specificity of all series combinations was 100 and the sensitivity of BTA-series FISH was the highest (73.2%). AO-F parallel FISH was the most valuable in the diagnosis of bladder cancer according to the calculation of AUROC,. Conclusion 1. The urine samples of this experiment are easy to collect, and the feasibility is high. 2. AO-FU BTA-FISH is of clinical significance in the diagnosis of bladder cancer. The diagnostic value of fish in bladder cancer was the highest. 4. The sensitivity of AO-F was positively correlated with the clinical stage and pathological grade of the tumor. AO-F parallel FISH is the most valuable method in the diagnosis of bladder cancer. It is suggested that AO-F and FISH can reduce the frequency of cystoscopy.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R737.14
本文編號：2219912
[Abstract]:Objective to evaluate the diagnostic value of acridine orange staining (AO-F), fluorescence in situ hybridization (Fish) and bladder tumor antigen (BTA) in the diagnosis of bladder epithelial carcinoma. To provide theoretical basis for early non-invasive diagnosis of bladder cancer. Method 1. A total of 82 urinary bladder patients from March 2016 to November 2016 in the second Hospital of Tianjin Medical University were collected. 27 patients with benign urinary system diseases were included in the control group. 2. 2. Collect urine samples from patients and group them. The urine samples were detected by acridine orange staining (AO-F), bladder tumor antigen (BTA) and fluorescence in situ hybridization (FISH). To analyze the diagnostic significance of AO-F,FISH,BTA alone in bladder cancer and the correlation between pathological grade and stage. 4. This paper discusses the significance of combined detection of three methods in the diagnosis of bladder cancer, including series detection and parallel detection. The diagnostic value of (ROC), in bladder cancer detection is compared by using SPSS18.0 to draw the operating curve of subjects by area (AUROC) under the curve. Results 1.The sensitivity of AO-FTA-FISH alone was 62.2 and 69.5%, and the specificity was 92.6 and 77.8% respectively. The sensitivity of FISH was the highest and the specificity of AO-F was the highest. The area under the curve of the three methods was 0.7740.736 and 0.816, respectively. The difference was statistically significant, showing that the diagnostic value of FISH was the greatest. 2. The sensitivity of AO-F in low-grade and low-grade tumors was significantly lower than that in high-grade and high-grade tumors, and the difference was statistically significant. Through the analysis of the results of combined detection of bladder cancer by three methods, the combined detection was divided into series and parallel cases: in the joint examination, the positive results were determined to be in series at the same time. If there is at least one positive test in the joint examination, the total positive result is determined to be parallel. The specificity of all series combinations was 100 and the sensitivity of BTA-series FISH was the highest (73.2%). AO-F parallel FISH was the most valuable in the diagnosis of bladder cancer according to the calculation of AUROC,. Conclusion 1. The urine samples of this experiment are easy to collect, and the feasibility is high. 2. AO-FU BTA-FISH is of clinical significance in the diagnosis of bladder cancer. The diagnostic value of fish in bladder cancer was the highest. 4. The sensitivity of AO-F was positively correlated with the clinical stage and pathological grade of the tumor. AO-F parallel FISH is the most valuable method in the diagnosis of bladder cancer. It is suggested that AO-F and FISH can reduce the frequency of cystoscopy.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R737.14
【參考文獻(xiàn)】
相關(guān)期刊論文 前2條
1 平秦榕;顏汝平;王劍松;;膀胱癌早期診斷方法的臨床價值[J];醫(yī)學(xué)與哲學(xué)(B);2015年03期
2 田振濤;徐勇;王錦;楊闊;;尿脫落細(xì)胞吖啶橙染色檢查在膀胱癌診斷中的應(yīng)用價值[J];中華泌尿外科雜志;2009年04期
，本文編號：2219912
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