RT-PCR检测膀胱移行细胞癌患者尿CK20 mRNA表达的研究

目的　探讨膀胱移行细胞癌 (TCCB)患者尿细胞角蛋白 2 0 (CK2 0 )mRNA表达及其意义。方法　采用逆转录聚合酶链反应 (RT PCR)检测 6 1例TCCB患者、19例非肿瘤患者及 11例健康志愿者尿脱落细胞CK2 0mRNA。结果　 6 1例TCCB患者中 5 2例尿脱落细胞CK2 0阳性表达 ,阳性率为 85 .3% ,对照组 30例中 2例表达 ,阳性率为 6 .7%。各分期尿CK2 0mRNA阳性率T1为 83.9% (2 6 / 31) ,T2 4期 86 .7% (2 6 / 30 ) ,两者差异无统计学意义 ;分级G1为 82 .8% (2 4 / 2 9) ,G2 85 .0 % (17/ 2 0 ) ,G3 91.7% (11/ 12 ) ,三者之间差异无统计学意义。行保留膀胱手术患者 5 1例 ,其中 4 2例术前尿CK2 0mRNA表达阳性 ,术后36例阴性 ,术后转阴率 85 .7%。 5 1例中有 2 9例 (术后尿脱落细胞CK2 0阳性表达 4例 )随访 6个月 ,4例CK2 0阳性表达者有2例 (5 0 % )复发 ,2 5例CK2 0阴性表达有 1例 (4 % )复发 ,两者复发率比较有统计学差异 (P <0 .0 0 5 )。结论　RT PCR检测尿脱落细胞CK2 0mRNA表达是诊断TCCB一种简便方法 ,其敏感性为 85 .3% ,特异性为 93.3% ,有助于膀胱TCCB的早期诊断和预后观察 ,可作为膀胱肿瘤的筛查标志物

Detection of CK20 in urine of patients with transitional cell carcinoma of the bladder

Objective To defect CK20 expression in the exfoliated urinary cells from transitional cell carcinoma of bladder (TCC) by using RT-PCR and to assess its clinical significance.Methods CK20 mRNA in exfoliated urinary cells of 61 patients with TCC,19 non-cancerous patients and 11 healthy volunteers were detected by using RT-PCR.Results Of 61patients with TCC 52 (85.3%) showed positive CK20 signals in urine.Only 2 of 30(6.7%) in control group showed positive CK20 signals in urine.The specificity was 93.3%.The positive rate of CK20 in urine were shown as follows:T1 83.9%(26/31),T2-4 86.7%(26/30);G1 82.8%(24/29),G2 85%(17/20),G3 91.7%(11/12)respectively.There was no correlation between the positive rate in TCC and pathologic grade or clinical stage.Of 42 preoperative CK20-positive patients 36 showed negative CK20 signals in urine after tumor removal and the negative rate of conversion was 85.7%.Of 51 patients who had been preformed operation 29 were made follow-up 6-months,2 of 4 postoperative CK20-positive patients suffered from recurrence,but only 1 of 25 postoperative CK20-negative patients suffered from recurrence during a 6 months follow-up period.Conclusions RT-PCR detection of urinary CK20 is precise and easy to be perform.It is applicable to detect cancer cells in urine of patients with TCC and may be helpful in early diagnosis and follow-up of TCC.