尿端粒酶、NMP22和ImmunoCyt联合检测在膀胱癌诊断中的应用

目的评价尿端粒酶、核基质蛋白22（NMP22）和ImmunoCyt测定在膀胱癌（BTCC）早期诊断中的应用价值,寻找早期诊断膀胱癌的有效方法。方法选择60例经病理诊断明确为早期膀胱移行细胞癌和60例非膀胱肿瘤患者,分别进行尿端粒酶、ImmunoCyt、NMP22和标准尿脱落细胞学检测。结果尿端粒酶、NMP22和ImmunoCyt和尿脱落细胞学的敏感度分别为58.3%、60.0%、61.6%、26.6%;准确度分别为75.8%,78.3%,78.3%和63.3%;特异度分别为93.3%,96.6%,95.0%和100%。三者联合检测与尿端粒酶、NMP22和ImmunoCyt单独检测相比,敏感度（分别为χ2=6.53,P〈0.05;χ2=5.17,P〈0.05;χ2=4.54,P〈0.05）和准确度（分别为χ2=4.01,P〈0.05,χ2=4.38,P〈0.05,χ2=4.91,P〈0.05）都有所提高;尿端粒酶、NMP22和ImmunoCyt联合检测的敏感度（χ2=28.06,P〈0.01）和准确度（χ2=16.2,P〈0.01）均高于尿脱落细胞学,差异有统计学意义。结论尿端粒酶、NMP22和ImmunoCyt是早期诊断膀胱移行细胞癌的一种高特异性指标,三者联合检测能提高膀胱癌的早期诊断率。

Significance of urinary telomerase, nuclear matrix protein 22 (NMP22) and ImmunoCyt in the early diagnosis of bladder transitional cell carcinoma

Objective To evaluate the clinical significance of urinary telomerase,nuclear matrix protein 22（NMP22） and ImmunoCyt in the early diagnosis of bladder transitional cell carcinoma（BTCC）.Methods The urinary telomerase,NMP22 and ImmunoCyt in 60 cases diagnosed as early BTCC and 60 controls were detected.Results The sensitivity of urinary telomerase,NMP22,ImmunoCyt and exfoliative cytology was 58.3%,60.0%,61.6% and 26.6%;the accuracy was 75.8%,78.3%,78.3% and 63.3%;the specificity was 93.3%,96.6%,95.0% and 100%.The diagnosis sensitivity（χ2=6.53,P0.05;χ2=5.17,P0.05;χ2=4.54,P0.05） and accuracy（χ2=4.01,P0.05;χ2=4.38,P0.05;χ2=4.91,P0.05） of combined detection of the three indexes were higher than the sensitivity（χ2=28.06,P0.01） and accuracy（χ2=16.2,P0.01） when the indexes were detected respectively,and were significantly higher than those of urinary cytology.Conclusion Urinary telomerase,NMP22 and ImmunoCyt are specific markers in the early diagnosis of BTCC.The combined detection can improve the early diagnosis rate of carcinoma of urinary bladder.