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 p16 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 p16 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 9p16 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 G1 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 p16 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.