尿核基蛋白22检测在膀胱癌诊断中的价值

目的:探讨尿核基蛋白22(NMP22)在膀胱移行细胞癌诊断中的临床价值。方法:采用ELISA法定量分析16例膀胱移行上皮癌(TCC)、14例TCC术后随访患者和12例泌尿系良性疾病患者的尿NMP22含量,并同时行尿脱落细胞学检查。设定NMP22的临界值为10U/ml。结果:16例膀胱移行癌患者、14例膀胱癌术后随访患者和12例泌尿系良性疾病患者的尿NMP22中位值分别为31.65、5.41和6.74U/ml,前者与后两者均有统计学差异(P<0.001)。以10U/ml为界值,尿NMP22诊断膀胱癌的敏感性为93.7%,特异性为69.2%,阴性预测值为94.7%,准确性为78.6%。同期尿细胞学的敏感性为31.3%,特异性100%,阴性预测值为70.2%。结论:与脱落细胞学比较,尿NMP22测定有更高的敏感性,是一种较理想的早期膀胱移行细胞癌诊断指标,对预后判断亦有价值。

Evaluation of nuclear matrix protein22 (NMP22) in urine for the diagnosis of bladder transitional cell carcinoma

Objective:To evaluate the role of urinary nuclear matrix protein,NMP22as an in-dicator for transitional cell carcinoma of the urinary tract.Methods:Fourty two patients were divided into3groups:16with transitional cell carcinoma(TCC),14with postoperative TCC,and12with uro-logical benign diseases.Each subject provided a single voided urine sample before operation or cys-toscopy,and each sample was divided into2aliqots on which NMP22and cytological examination were performed respectively.Results:In urinary benign disease and follow-up groups,the median NMP22value was5.41and6.47U/ml respectively.The median NMP22level in patients with TCC was31.65U/ml,which significantly higher than those of two other groups(P<0.001).When the cut-off value was set at10U/ml,the sensitivity of urinary NMP22for TCC was93.7%,the specificity69.2%and the negtive predictive value94.7%.The sensitivity of voided cytology was only31.3%.Conclusion:Urinary NMP22is an useful diagnostic marker as a substitute for voided-urine cytology for the surveil-lance of TCC.