尿脱落细胞CK20检测在膀胱癌诊断中的价值

目的:检测膀胱癌患者尿脱落细胞细胞角蛋白20(CK20)表达情况并探讨其在膀胱癌诊断中的价值。方法:应用RT-PCR方法分别检测35例膀胱癌患者、8例泌尿生殖系良性疾病患者及4例健康自愿者尿脱落细胞CK20表达情况,并与尿脱落细胞学检查结果进行比较。结果:35例膀胱癌患者中有26例的自排尿标本中可检测出CK20(敏感度为74.29％)。尿脱落细胞学检测阳性例数则为12例(敏感度为34.29％)。前者与后者比较差异有显著性意义(P<0.05)。8例泌尿生殖系良性疾病患者及4例健康自愿者的自排尿标本中无一例可检测出CK20(特异性为100％)。不同分化程度及不同临床病理分期膀胱癌患者之间尿脱落细胞(2K20阳性表达率的差异有显著性意义(P<0.05)。结论:尿脱落细胞CK20检测的敏感性及特异性均高,有望成为膀胱癌诊断和术后复发监测的一种有效手段。

Cytokeratin 20 assay in exfoliated urothelial cells is valuable in the diagnosis of bladder cancer

Purpose: To detect the cytokeratin 20 in exfoliated urothelial cells of patients with bladder cancer and to evaluate its value in the diagnosis of bladder cancer. Methods: Cytokeratin 20 expression was studied by mean of reverse transcriptase polymerase chain reaction (RT-PCR) in voided urine samples from 35 cases of bladder cancer and 8 patients with benign urogenital diseases and 4 healthy volunteers. Results:Cytokeratin 20 was detected in 26 of 35 bladder cancer urine samples (Sensitivity 74. 29%) , while urinary cytology was positive in 12 of 35 (Sensitivity 34. 29%). The sensitivity between cytokeratin 20 assay and urinary cytology had significant difference ( P <0. 05). In 8 benign urogenital disease patients and 4 healthy volunteers, none could be detected expression of cytokeratin 20 (Specificity 100%). There were significant different positive expression rates in urine exfoliated cells from the bladder cancer patients with different grades or clinicopathological stages ( P <0. 05). Conclusions: RT-PCR assay to detect cytokeratin 20 in urine exfoliated cells would be a sensitive and specific methods in i-dentification and monitoring of patients with bladder cancer.