膀胱移行细胞癌患者尿液粘蛋白MUC1定量检测的临床意义

目的研究上皮特异性肿瘤蛋白MUCl在膀胱移行细胞癌患者尿液中的表达，探讨尿液MUCl在膀胱癌早期诊断、疗效评估、预后判断中的价值。方法采用放射免疫法（IRMA）检测31例膀胱移行细胞癌患者、10例腺性膀胱炎患者、10例非膀胱泌尿系良性疾病及10例正常对照组尿液MUC1的表达水平，分析各组组间、不同分期和分级患者、初发与复发患者及术前与术后患者尿液MUC1的差异。结果膀胱肿瘤组患者尿液MUC1同各组尿液MUC1含量相比较。差异无显著性（P〉0．05）。膀胱肿瘤组中，不同分级、分期肿瘤患者尿液MUC1差异无显著性（P〉0．05），初发和复发肿瘤患者尿液MUC1差异无显著性（P〉0．05），而术前与术后肿瘤患者尿液MUC1差异有显著性（P＜0.05）。结论尿液MUC1不能作为膀胱癌的早期诊断筛选指标，但可作为疗效评价、预后判断的指标。MUC1属肿瘤基因表型瘤标。组织学的高表达并不一定平行于血液和尿液，特异性肿瘤基因瘤标应该是膀胱移行细胞癌早期诊断筛选指标的研究方向。

Value of quantitative examination of urine MUC1 in bladder transitional cell carcinoma

OBJECTIVE: To evaluate the value of quantitative examination of MUC 1 in the urine of patients with bladder transitional cell carcinoma (BTCC). METHODS: Urine samples were obtained from 31 patients with BTCC for quantification of MUC 1 content by immunoradiometric analysis. The urine samples were also examined in 10 patients with cystitis glandularis, 10 with benign urine disease and 10 healthy volunteers. The differences in urine MUC1 content were statistically measured between the groups, between cancer patients of different clinical stages and classes, between primary and recurrent cancer patients, and between measurements taken before and after operation. RESULTS: Urine MUC 1 was detected in all the patients. No significant differences were found between the groups, nor between patients with BTCC in all stages (P>0.05), or between primary and recurrent cancer patients (P>0.05). But MUC 1 contents showed significant difference before and after the operation in the cancer patients (P<0.05). CONCLUSIONS: Urine MUC 1 can not serve as the marker to screen and diagnose BTCC, but it can be useful in therapeutic effect and prognostic evaluation. Specific oncogene markers are more significant than oncogene phenotype markers in clinical diagnosis and screen of BTCC.