尿膀胱癌抗原、CYFRA21-1和透明质酸在膀胱癌诊断中的价值

目的：评价尿膀胱癌抗原（urinary bladder cancer antigen,UBC）、CYFRA21-1和透明质酸（hyaluronic acid,HA）在膀胱癌诊断中的应用价值。方法：采用ELISA法检测53例膀胱癌患者、25例泌尿系统良性疾病患者和13名健康志愿者的尿UBC,并采用RIA法检测其CYFRA21-1和HA,同时行尿细胞学检查。结果：①通过ROC曲线确定UBC、CYFRA21-1和HA的最适临界值分别为7.5μg/L、2.85ng/mL和154.47ng/mL,3种尿肿瘤标志诊断膀胱癌的灵敏度分别为86.8%、86.8%、71.7%,与尿细胞学检查（32.1%）相比差异均有统计学意义（P〈0.01）;4种方法的特异度分别为76.3%、78.9%、84.2%、97.4%;阳性预期值分别为83.6%、85.2%、86.4%、94.4%;阴性预期值分别为80.6%、81.1%、68.1%、50.7%。②3种尿肿瘤标志联合检测诊断灵敏度可提高至96.2%。结论：尿UBC、CYFRA21-1和HA检测技术简便,具较高的灵敏度和特异度,其联合检测更有助于诊断膀胱癌。

Value of urinary bladder cancer antigen,CYFRA21-1 and hyaluronic acid in the diagnosis of bladder cancer

Objective To evaluate the clinical efficacy of urinary bladder cancer antigen,CYFRA21-1 and HA as the tumor markers for bladder cancer. Methods UBC, CYFRA21-1 and HA tests were carried out for the urine samples from 53 cases of bladder cancer、25 cases of urological benign disease and 13 cases of healthy individuals by an enzyme-Linked immunosorbent assay（ELISA）、radioimmunology assay（RIA）, respectively; and cytology were carried out for each patient. Results At a threshold value of 7.5 μg/L、2.85 ng/mL、154.47 ng/mL, the sensitivity of UBC、CYFRA21-1 and HA （86.8%、86.8%、71.7%） for detection bladder cancer was significantly better than the urinary cytology（32.1%）（P〈0.01）, The specificity of UBC、CYFRA21-1、HA and urinary cytology was 76.3%、78.9%、84.2%、97.4%, respectively. The positive predictive values of four tests was 83.6%、85.2 %、86.4%、94.4%, and the negative predictive values was 80.6%、81.1%、68.1%、50.7%, respectively. The combined use of three markers increased the sensitivity to 96.2%. Conclusions The study indicates that UBC、CYFRA21-1 and HA tests as the urinary tumor markers for the detection of bladder cancer are simple、sensitive、specific and noninvasive. The combined use of three markers increased the diagonostic value of bladder cancer.