膀胱肿瘤抗原检测膀胱癌的临床意义

目的 探讨膀胱肿瘤抗原（ＢＴＡ）对膀胱癌早期诊断的意义。方法 以ＢＴＡ和尿脱落细胞（ＶＵＣ）对３６例膀胱癌进行对比性检测。结果 ＢＴＡ的敏感性为４４．４％，ＶＵＣ为１６．６％，两者有显著性差异（Ｐ〈０．０１）。在早期膀胱癌，ＢＴＡ的敏感性为ＶＵＣ的６倍，进展期是ＶＵＣ的２．５倍。ＢＴＡ的特异性为９０％。结论 ＢＴＡ是一种简便、快速、无创伤性的检测方法，敏感性明显高于ＶＵＣ，尤其是早期膀胱癌中有较高     

BTA在膀胱癌诊断中的应用

为了探求对膀胱肿瘤诊断及术后复发监测的理想手段，从１９９５年９月～１９９６年６月，采用ＢＴＡ试剂检测方法对２０２例血尿患者及７１例膀胱肿瘤术后的患者进行了诊断检测，诊断膀胱癌的敏感度为９６％、特异度为８３％、准确度为８６％，２６例膀胱肿瘤患者中仅６例（２３％）尿脱落细胞阳性，正常对照均为阴性。认为ＢＴＡ试剂是一种快速、有效、无创性诊断膀胱肿瘤的方法。     

影响尿核基质蛋白诊断膀胱癌的干扰因素

目的：探讨尿核基质蛋白(NMP22)在膀胱癌诊断中的特异性和阳性预测值价值。方法：对196例临床怀疑膀胱癌的患者，在膀胱镜检查前留取新鲜自排尿．每个尿标本均行尿细胞学、尿常规、尿培养和NMP22检测。所有患者均行膀胱镜检查。结果：196例中，病理检查证实膀胱癌41例，其他疾病155例。41例膀胱癌患者中，检测出NMP22 33例(80．5%)，而尿细胞学检测阳性仅为11例(26．8％)。在67例NMP22异常者中，除33例诊断为膀胱癌外，假阳性为34例，故特异性和阳性预测值分别为78．1％和49．3％。假阳性结果主要出现在泌尿系感染或炎症、泌尿系结石、泌尿系异物、肠道代膀胱、其他泌尿生殖系肿瘤和器械操作6种情况．排除这6种干扰因素后，NMP22检测的特异性和阳性预测值分别升高至96．2％和91．7％。结论：排除干扰因素能明显改善NMP22诊断膀胱癌的特异性和阳性预测值，提高其临床应用价值。     

单克隆抗体阿霉素介联物导向治疗膀胱癌的临床研究

抗人膀胱癌单克隆抗体ＨＢＴＡ通过葡聚糖与阿霉素联交成化学免疫偶联物对７例膀胱癌病人进行免疫导向治疗。病人接受ＨＢＴＡ抗体蛋白量为１５ｍｇ－５０ｍｇ，平均４０ｍｇ。治疗后７例病人的肿瘤组织经济免疫组化检测均呈阳性的抗体定位，血清膀胱肿瘤相关抗原显著降低（Ｐ＜０．０１），电镜观察到治疗后肿瘤细胞超微结构坏死变。结果表明以鼠抗人膀胱癌单克隆抗体与化疗药物偶联制各的生物导弹能安全地用于临床，并能特异性地在     

膀胱肿瘤抗原临床应用效果与评价（附112例报告）

为探讨膀胱肿瘤患者早期诊断的有效方法，对１１２例怀疑或确诊为膀胱肿瘤的患者进行膀胱肿瘤抗原（ＢＴＡ）测定。结果ＢＴＡ诊断膀胱肿瘤的敏感性为７７．４％略低于膀胱镜检查（９６．４％）但明显高于尿脱落细胞学检查（１１．５％）同时ＢＴＡ的阳性率随着肿瘤的分级增加而增高。认为ＢＴＡ测定是膀胱肿瘤早期诊断，预后监测较为灵敏的指标，并具有快速，安全，无创伤的特点，值得在临床上推广应用。     

联合检测血清和尿液中透明质酸诊断膀胱癌的探讨

目的：探讨血清和尿液中透明质酸（HA）与膀胱癌的关系及其临床意义。方法：应用放射免疫分析（RIA）方法对47例膀胱癌患者术前血清和尿液中HA水平进行测定，并对其进行对比分析。结果：膀胱癌患者术前血清和尿液中HA水平分别为（221．04±86．04）ng／ml和（381．21±97．12）ng／ml，明显高于正常对照者（P〈0．01）；膀胱癌患者术前尿液HA水平与肿瘤的分级和分期密切相关（P〈0．01），但血清HA水平与肿瘤的分级和分期无相关性（P〉O．05）；术前尿液中的HA水平稍高于血清水平，但差异无统计学意义（P〉0．05）。以大于正常对照者血液和尿液中HA水平上限102．91ng／ml、144．70ng／ml为阳性界值时，检测血清和尿液HA的阳性率和敏感性为85．10％和89．36％，两者差异无统计学意义（P〉0．05），其阳性预测值分别为100％、97．67％，阴性预测值分别为100％、64．28％。结论：HA在膀胱癌患者外周血和尿液中均表达增高，可能参与膀胱癌的发生和发展，可作为检测膀胱癌的指标。     

膀胱癌患者尿NMP22测定的临床意义

目的：评价尿核基质蛋白22（NMP22）在膀胱癌诊断和预后判定中的应用价值。方法：采用ELISA法测定18例膀胱癌和20例泌尿系良性疾病患者尿液中NMP22值,及10例膀胱移行细胞癌患者术后尿NMP22值。结果：18例膀胱癌患者尿NMP22的中位值为44．3IU／L,20例泌尿系良性疾病患者尿NMP22的中位值为5．8IU／L,二者相比判别有显著性意义（P＜0．02）。以10IU／L为临界值,诊断膀胱癌的敏感性为83％,特异性为70％,阴性预测值为82％。10例膀胱移行细胞癌患者术后尿NMP22中位值为7．8IU／L,与术前相比明显下降（P＜0．01）。尿NMP22在肿瘤分级间的差别无显著性意义。结论：尿NMP22作为一种灵敏、简便的早期诊断膀胱癌的瘤标,对于预后判断可能具有应用价值。     

膀胱癌C—ergbB—2基因产物及表皮生长因子受体的免疫组化研究

用免疫组织化学法对５６例膀胱癌和４例正常膀胱组织的原癌基因Ｃ－ｅｒｂＢ－２产物及表皮生长因子受体进行检测。结果发现：３５％（２０／５６）的膀胱癌Ｃ－ｅｒｂＢ－２基因产物为阳性，随着肿瘤组织分级上升，该基因产物的表达也增高。     

检测膀胱癌患者尿液脱落细胞中Survivin的表达及意义

目的：探讨检测膀胱癌患者尿液脱落细胞中Survivin的表达及意义。方法：留取40例膀胱移行细胞癌患者、15例其他泌尿系统疾病患者和8例正常健康成人的新鲜尿液，离心收集脱落细胞，以逆转录多聚酶联反应(RT-PCR)检测膀胱癌患者尿液脱落细胞中Survivin的表达．并行尿脱落细胞学检查。结果：40例膀胱移行细胞癌患者尿脱落细胞中有38例检测出Survivin表达，而15例其他泌尿系统疾病患者和8例正常健康成人的尿脱落细胞中均未检测出Survivin的表达。以RT-PCR反应检测膀胱癌患者尿液脱落细胞中Survivin的方法敏感性为95％，特异性为100％。结论：初步的试验结果显示．RTPCR法检测膀胱癌患者尿液脱落细胞中Survivin的方法可以作为诊断膀胱癌的无创性方法。     

抗人膀胱癌单克隆抗体^188Re标记及荷瘤裸鼠体内放射性 …

目的 制备放射免疫导向药物用以诊断和治疗膀胱癌。方法 通过２颈基直接带原标记法将放射性核素＾１８８Ｒｃ（＾１８８铼）标记抗人膀胱癌单克隆抗体ＢＤＩ－１,标记产物＾１８８Ｒｃ－ＢＤＩ－１经尾静脉注入荷人膀胱癌裸鼠体内,检测其在裸鼠体内,肿瘤对＾１８８Ｒｅ－ＢＣＩ－１标记率为３０％,放射化学纯度为９０％,免疫尖性分数为５８．６８％。在裸鼠体内,肿瘤对＾１８８Ｒｅ－ＢＤＩ－１的摄取率在２３ｈ达到高峰,发     

NMP22与BTA stat检测在膀胱肿瘤诊断中的应用

目的评价NMP22和BTAstat诊断膀胱肿瘤的价值.方法对82例临床怀疑膀胱肿瘤的患者,在膀胱镜检查前将尿样分为3份,分别进行NMP22、BTAstat和脱落细胞学检测,分析比较3种方法的敏感性、特异性和阳性预测价值.结果82例中病理证实膀胱肿瘤32例,其他疾病50例.NMP22诊断膀胱肿瘤敏感性为87.5%,与BTAstat(65.6%)、细胞学(21.9%)比较,差别有显著性意义(P<0.05).3种方法诊断特异性分别为84.0%、64.0%和100.0%.阳性预测值分别为77.8%、53.9%和100.0%.结论NMP22是一种简单、敏感、非侵袭性的早期诊断膀胱肿瘤的肿瘤标记物.     

膀胱肿瘤抗原联合尿脱落细胞学检查在膀胱肿瘤诊断中的价值

目的 探讨膀胱肿瘤抗原(BTA)联合尿脱落细胞学检查在膀胱肿瘤诊断中的应用价值.方法 收集2018年9月至2019年9月本院经膀胱镜检查或手术后病检确诊的膀胱肿瘤(37例)及非膀胱肿瘤(32例)患者的尿液标本,分别行尿脱落细胞学及BTA检测并进行相关分析.结果 ①尿BTA诊断前列腺肿瘤的灵敏度(81.08％)高于尿脱落...     

Evaluation of the BTA tests for the detection of bilharzial related bladder cancer: the Cairo experience

OBJECTIVE: To evaluate the clinical performance of the BTA stat test and the BTA TRAK assay in the diagnosis of bilharzia-related bladder cancer and to calculate a new 'Egyptian' cut-off value for the BTA TRAK (quantitative) assay. METHODS: Urine samples of 149 individuals were tested for the presence of the human complement factor H-related protein, the antigen detected by the BTA stat and BTA TRAK tests. The group consisted of 53 healthy volunteers, 20 patients with active bilharziasis, 11 patients with other urologic disorders including prostate cancer, and 65 patients with histologically proven bladder cancer. All samples were obtained prior to surgery or therapy. RESULTS: The BTA stat test was positive in 64 of 65 samples from patients with bladder cancer, for an overall sensitivity of 99%. With a BTA TRAK assay cut-off of 60 U/ml (set at 97% specificity in the healthy population), the sensitivity of the TRAK assay was 94%. There was no statistically significant difference between the sensitivities of the two BTA tests in patients diagnosed with squamous cell carcinoma and those with transitional cell carcinoma. The overall specificity of the BTA stat test was 67% ranging from 15% in patients with bilharziasis to 94% in healthy volunteers. The overall specificity of the TRAK assay was 66%, again with negative results in 15% of the patients with bilharziasis. CONCLUSIONS: The BTA stat test and TRAK tests are extremely sensitive in the detection of bladder cancer in the Egyptian population. Positive results (85%) are also observed in patients with active bilharziasis, which often leads to bladder cancer. Longitudinal follow-up of these positive cases is needed to determine whether these positive results are false or predictive of bladder cancer.     

联合核基质蛋白22 与膀胱肿瘤抗原监测膀胱肿瘤复发的意义

目的：探寻无创、快速、便捷的监测膀胱肿瘤复发的方法。方法：对90例TURBt术后患者，采用标准ELISA法检测尿核基质蛋白22（NMP-22）值，同时采用单抗免疫分析法测定膀胱肿瘤抗原（BTAstat）、膀胱镜检及病理检测有无肿瘤复发。结果：与膀胱镜检及活检结果相比，尿NMP-22检测可发现77％（33/43）复发病例，尿BTAstat检测可发现67％（29/43）复发病例。2项检测综合分析，检测准确率升至93％（40/43）。结论：尿NMP-22检测为快速、高效、便捷的监测膀胱肿瘤复发的方法，联合BTAStat检测可提高准确率，减少膀胱镜检频率。     

Comparison of the nuclear matrix protein 22 with voided urine cytology and BTA stat test in the diagnosis of transitional cell carcinoma of the bladder.

OBJECTIVE: To assess sensitivity, specificity, accuracy, positive predictive value and negative predictive value of nuclear matrix protein 22 (NMP22) test, BTA stat test and cytology in the urine of patients with a spectrum of urologic conditions, including bladder cancer. METHODS: A total of 140 patients (40 with bladder cancer) provided a urine sample which was divided into appropriate aliquots for each of the tests cited above. The endoscopist, pathologist, cytologist and the person performing BTA stat test and NMP22 test were blinded as to the results of the other tests. RESULTS: Receiver-operating characteristics curve interpretation determined that 12.0 U/ml was an optimal reference value for NMP22 to detect transitional cell carcinoma of the bladder in this patient group. Comparative results demonstrate a clear superiority of NMP22 and BTA stat tests in sensitivity in bladder cancer detection (p < 0.01), while cytology and NMP22 were better than BTA stat test in specificity (p < 0.05). CONCLUSIONS: NMP22 and BTA stat test results represented significant improvement over urinary cytology for detection of transitional cell carcinoma. The sensitivities of NMP22 and BTA stat tests for detection of transitional cell carcinoma in this group of patients were as much as twice that of cytology. When the cutoff value of urinary NMP22 was set at 12.0 U/ml, NMP22 was more accurate than the other tests (p < 0.05).     

尿细胞学、BTA、B超联合检查在膀胱癌病人随访中的应用

目的　了解联合应用尿细胞学、尿BTA、经腹B超检查在膀胱癌术后病人随访中的价值。方法　对 31例膀胱癌术后随访病人 ,先行尿细胞学、尿BTA、经腹B超检查 ,再行膀胱镜检查。以膀胱镜检查及活检为金标准 ,分析各种检查的效果。　结果　 31例经膀胱镜检查及活检证实肿瘤复发 14例。尿细胞学、尿BTA、经腹B超检查的灵敏度分别为 5 0 .0 %、78.6 %、6 4.3 %。三种检查联合应用的灵敏度为 92 .9% ,与膀胱镜检查比较 ,统计学差别无显著性意义。　结论　尿细胞学、尿BTA、经腹B超联合检查可以部分取代膀胱镜检查用于膀胱癌病人的术后随访     

Human complement factor H related protein test for monitoring bladder cancer

PURPOSE: The BTA stat test is a rapid, noninvasive, qualitative urine test that detects bladder tumor associated antigen (human complement factor H related protein) in urine. We compared BTA stat test to voided urine cytology in patients monitored for bladder cancer in a prospective trial, and determined whether this test is effective in detection of recurrence not seen by regular cystoscopy. MATERIALS AND METHODS: A total of 445 consecutive patients with bladder cancer were studied. A voided urine sample was obtained before cystoscopy and divided for culture, cytology and BTA stat testing. In cases of a positive BTA stat test but negative cystoscopy, excretory urography or renal ultrasound, random biopsies and collected ureteral urine samples for ureteral cytology were obtained. The overall sensitivity and specificity as well as positive and negative predictive values for BTA stat test, cytology and their combination were calculated. RESULTS: Of the 445 patients 118 (26.5%) had bladder cancer recurrence on cystoscopy, which was detected by BTA stat test and cytology in 63 (53.4%) and 21 (17.8%), respectively. Of the remaining 327 patients not having recurrent tumor on cystoscopy 81 (24.8%) had a positive BTA stat test. Excretory urography or renal ultrasound and random biopsies in 48 (59.3%) of these patients revealed 7 recurrences, making the total number of recurrent tumors 125 of 412 (30.3%). The overall sensitivities and specificities for the BTA stat test, cytology and their combination were 56.0%, 19.2%, 60.0% and 85.7%, 98.3% and 85.0%, respectively. CONCLUSIONS: The sensitivity for detection of recurrent tumor on BTA stat test is superior to that of voided urine cytology in all bladder cancer categories, whereas the specificity of voided urine cytology is higher than that for BTA stat test. However, a sixth of the patients with apparent false-positive BTA stat test results chosen for further investigation had recurrent tumors that were not found on routine cystoscopy. Although the sensitivity and specificity were highest when both tests were used, the differences were not significant overall. Therefore, the BTA stat test could potentially replace urine cytology for followup of superficial bladder cancer.     

几种新瘤标对膀胱癌早期诊断价值的比较

目的：比较几种新瘤标对膀胱移行细胞癌早期诊断的价值。方法：对322例肉眼或镜检血尿、膀胱刺激症状或发现膀胱占位者，在作膀胱镜检查前行尿液中细胞角蛋白20(CK20)、核基质蛋白(NMP22)、ImmunoCyt、膀胱肿瘤抗原(BTA stat)检测和常规尿细胞学检查，比较它们的敏感性和特异性。结果：经膀胱镜和病理检查诊断膀胱移行细胞癌149例，其中浅表性肿瘤110例，浸润性39例；G181例，G246例．G322例。CK20、NMP22、ImmunoCyt、BTA stat、尿细胞学和膀胱镜检的敏感性分别为90．6％、85．2％、82．6％、65．8％、30．2％和94．6％，特异性分别为83．6％、84．0％、78．1％、64％、100％和100％。结论：新瘤标CK20、NMP22、ImmunoCyt具有较高的敏感性，与BTA stat和尿细胞学比较，差异有统计学意义，可用于膀胱肿瘤的早期诊断。     

Comparison of BTA stat and NMP22 tests in the detection of bladder cancer

OBJECTIVE: This study aimed to compare the BTA (bladder tumour antigen) stat and urinary nuclear matrix protein (NMP22) tests in the detection of bladder cancer. MATERIAL AND METHODS: The office-based qualitative BTA stat and the laboratory-based quantitative NMP22 tests were studied in the same urine samples obtained from 49 patients with a high suspicion of bladder cancer and 20 healthy subjects. RESULTS: A tumour was identified in 36 patients after the cystoscopy. BTA stat demonstrated a sensitivity of 89%, which was superior to the sensitivity of 66.6% with the NMP22 test in detecting the bladder cancer (p < 0.02). The sensitivities for grade I tumours with BTA stat and NMP22 were 55.5% and 33.3%, respectively. The sensitivity of BTA stat was 100% for tumour categories except for the pTa and grade I tumours. No positive result was observed with both tests among the healthy subjects. The specificities for BTA stat and NMP22 were 78.7% and 69.6%, respectively. CONCLUSIONS: The BTA stat test was significantly more sensitive than the NMP22 test in the detection of bladder cancer. Although the sensitivity of BTA stat was not sufficient to replace cystoscopy, its ease and low cost may play a role in reducing the number of control cystoscopies, especially in patients with low risk of progression.