A Study on Mass-Screening Test for Detection of Bladder Cancer by Automated Urine Cytology

在几个肿瘤系统中，肿瘤内异常脱氧核糖核酸（DNA）含量的存在与临床恶性程度之间存在明显的直接相关性。现代流式细胞术通过对单个细胞的检测，可以快速检测复杂细胞混合物中的DNA。因此，该分析方法可用于尿液标本中恶性细胞的定量和客观检测，并可应用于自动尿液细胞学检查。为评价膀胱冲洗液流式细胞术DNA检测（FCM）在膀胱癌诊断中的价值，对尿脱落细胞学、膀胱冲洗液细胞学和FCM进行了敏感性比较。对56例经病理证实的膀胱移行细胞癌患者的76份标本进行流式细胞术检测，结果显示流式细胞术比尿脱落细胞学和/或膀胱冲洗液细胞学更敏感。同时也发现FCM可能在尿细胞学检查明显之前提示尿路上皮肿瘤， ...更多信息 特别是在炎症的背景下。因此，流式细胞术被认为是有价值的发现在可疑人群中或随访病例诊断膀胱癌。然而，由于检测低级别肿瘤的灵敏度较低，因此需要潜在的发展和进一步的改进。在这方面，进行流式细胞术DNA/溴脱氧尿苷（BrdU）双变量分析是否该技术可以提供更多的信息，膀胱癌的恶性潜力比DNA分析单独。结果56例膀胱肿瘤中DNA/BrdU双色FCM可作为膀胱癌恶性潜能定量的客观指标。因此，FCM技术比经典细胞学更有优势，因为：1）更高的灵敏度，2）早期预测性和3）更客观和定量分析。同时，通过计算机辅助图像分析进行恶性肿瘤细胞检测。到目前为止，该方法可以区分白色血细胞、红细胞、上皮细胞和晶体。此外，由于高核/细胞比，可鉴定高级别肿瘤细胞。然而，低级别肿瘤细胞的澄清困难，这一结果表明，需要进一步鉴定肿瘤特异性标志物，以改进该方法作为常规实验室程序。少

A direct correlation clearly exists between the presence of abnormal deoxyribonucleic acid (DNA) contents within the tumors and the degree of clinical malignancy in several tumor system. The modern flow cytometric technique can measure DNA in complex cell mixtures via individual cell examination at the tremendous rate. Therefore, this analysis can be uterized quantitative and objective detection of malignant cells in urine sample which can be applied to automated urine cytology. In order to evaluate flow cytometric DNA measurement (FCM) of bladder washing in the diagnosis of bladder cancer, the sensitivity of voided urine cytology, bladder washing cytology and bladder washing FCM was tested. The results from 76 samples from 56 patients with histologically proven transitional cell carcinoma of the bladder, FCM is more sensitive than voided urine cytology and/or bladder washing cytology. Also was found that FCM may indicate urothelial neoplasia before it is apparent on urine cytology, es … More pecially against a background of inflammation. Therefore, FCM is thought to be valuable for case finding in suspected population or for follow-up cases with diagnosed bladder cancer. However, potential developments of, and further improvements is needed since the sensitivity for detecting low-grade-tumor was low. In this regard, flow cytometric DNA/bromodeoxyuridine (BrdU) bivariate analysis was performed whether the technique can provide further information on the malignant potential of bladder cancer than DNA analysis alone. Results from a total of 56 bladder tumors, DNA/BrdU two-color FCM can provide an objective parameter for quantification of the malignant potential of bladder cancers. Thus, FCM technique is advantageous than classical cytology because of ; 1) higher sensitivity, 2) early predictability and 3) more objective and quantitative analysis. Meanwhile, malignant tumor cell detection by computer-assisted image analysis was performed. So far, the method can differentiate white blood cell, red blood cell, epithelial cell and crystals. Also, high-grade tumor cell can be identified because of high-nuclear/cell ration. However, difficulty of clarification on low-grade tumor cell were found. This result indicate that further identification of tumor-specific markers are needed for improvement of this method as routine laboratory procedures. Less