尿膀胱癌抗原、透明质酸和存活素联合检测对膀胱癌的诊断运用探讨

目的探讨在对膀胱癌的诊断过程中,尿膀胱癌抗原、透明质酸和存活素的应用价值。方法膀胱癌患者74例,泌尿系统良性疾病患者20例,健康志愿者标本10例分别行膀胱癌抗原(UBC)、透明质酸(HA)、存活素(Sur-vivin)和尿脱落细胞学(UC)检查。结果 UBC、HA、Survivin和尿脱落细胞学的检测有利于膀胱癌的诊断,且UBC、HA、Survivin三者的有效性优于尿脱落细胞学的检测。UBC、HA、Survivin在检测膀胱癌的过程中,三者的敏感性和准确性高于尿脱落细胞学。UBC、HA、Survivin在肿瘤的各分级(G1、G2、G3)和各分期(pTa、pT1、≥pT2)中的敏感性明显高于尿脱落细胞学。结论尿膀胱癌抗原、透明质酸和存活素在诊断膀胱癌过程中应用价值优于尿脱落细胞学。     

尿Cox-2蛋白和Survivin蛋白诊断膀胱移行细胞癌的临床价值

目的 探讨尿Cox-2蛋白、尿Survivin 蛋白和尿脱落细胞学检查诊断膀胱移行细胞癌的临床价值。方法 选择60例膀胱移行细胞癌和30例非膀胱肿瘤患者，同时行尿Cox-2蛋白、尿Survivin蛋白和尿脱落细胞学检查。结果 尿Cox-2蛋白、尿Survivin 蛋白和尿脱落细胞学的敏感性分别为88.3%，68.3%，21.7%；特异性分别为93.3%、80.0%和100%；Youden指数分别为81.6%、48.3%和21.7%。尿Cox-2的敏感性和Youden指数高于尿Survivin (P<0.05)，同时尿Survivin的敏感性和Youden指数高于尿脱落细胞学(P<0.05)。结论 尿Cox-2蛋白和尿Survivin蛋白是诊断和随访膀胱移行细胞癌的一种高敏感性和高特异性的指标，非常适合于复发率很高的膀胱癌的诊断与随访。     

ImmunoCyt和尿脱落细胞学检查对膀胱移行细胞癌的早期诊断价值

【目的】探讨ImmunoCyt检查在膀胱移行细胞癌早期诊断和随访中的作用。【方法】2006年9月至2008年3月对可疑膀胱癌患者138例,其中25例经尿道膀胱肿瘤电切术后的随访者,113例有肉眼或镜下血尿患者,分别进行尿脱落细胞学和ImmunoCyt检查。所有病人均行膀胱镜检查,对可疑组织活检。【结果】膀胱镜检和病理证实34例为膀胱移行细胞癌。ImmunoCyt敏感性为88．2％,与尿脱落细胞学检查（47．1％）相比差异有显著性意义（PdO．05）。两种检查方法相结合的敏感性为91．2％。ImmunoCyt和尿脱落细胞学的特异性分别为80．4％和95．3％。【结论】早期检出膀胱癌ImmunoCyt较尿细胞学更敏感,二者结合使用可在保持高特异性的同时提高敏感性,适合大规模可疑人群的普查及复发可能性较小的低级、低期膀胱癌的术后随访。     

尿survivin mRNA诊断膀胱移行细胞癌的临床价值

目的：评价尿survivin mRNA诊断膀胱移行细胞癌的临床价值。方法：80例膀胱肿瘤和30例非膀胱肿瘤患者,同时行尿survivin mRNA和尿脱落细胞学检查,比较各方法的敏感性、特异性。结果：尿survivin mRNA和尿脱落细胞学的敏感性分别为95.0%、36.2%;特异性分别为96.7%和100%。尿survivin mRNA检测的敏感性高于尿脱落细胞学检查（P〈0.05）。结论：尿survivin mRNA检测的高敏感性、高特异性为膀胱癌提供了一个简单无创的检测方法。     

通讯地址：广东省兴宁市官汕路中医医院检验科 514500

【】目的：研究分析尿核基质蛋白-22测定在膀胱癌诊断中的应用价值。方法：随机抽取我院2015年9月到2017年3月间收治的疑似膀胱癌患者50例作为研究对象,采用酶联免疫法对其尿样中的核基质蛋白-22水平进行测定,并行尿脱落细胞学检查,分别计算两种方法检查时患者的诊断阳性率。以患者的最终组织病理学诊断结果为依据,对核基质蛋白-22水平测定与尿脱落细胞学检查诊断膀胱癌的灵敏度、特异性、准确度进行计算,同时分析核基质蛋白-22水平与膀胱癌患者病理分级之间的相关性。结果：核基质蛋白-22水平测定、尿脱落细胞检查诊断膀胱癌的阳性率分别为66.00%和16.00%,检测灵敏度分别为86.67%、40.00%,特异性分别为42.86%、94.29%,准确度分别为56.00%、78.00%,核基质蛋白-22水平测定在检测阳性率、灵敏度上均显著高于尿脱落细胞检查,而检测特异性和总的准确度低于尿脱落细胞检查,比较均有统计学差异(P＜0.05)。在组织病理学检查确诊为膀胱癌的患者中,核基质蛋白-22检测水平随病理分级的升高而升高,且各级检测结果的比较均有统计学差异(P＜0.05)。结论：核基质蛋白-22测定应用于膀胱癌的筛查中,具有较高的灵敏度,且其检测水平与膀胱癌患者的病理分级之间存在显著相关性,可以将其作为膀胱癌的首选筛查方法,颇具临床应用价值。     

应用细胞角素20和存活素预测膀胱癌复发的初步研究

【目的】评价细胞角素20(CK20)和存活素(Survivin)在膀胱癌复发预测中的价值。【方法】应用免疫组织化学技术,检测膀胱癌组织中的CK20和Survivin蛋白表达,分析CK20和Survivin在浅表性膀胱癌组织中的表达差异,观察表达差异对肿瘤复发的预测价值。【结果】42例初发的浅表性膀胱癌(病理分级为G1和G2)中10例为CK20正常表达方式,32例为异常表达方式。随访36~65个月,中位随访时间为47个月。共有15例复发,均出现于CK20异常表达方式中。24例Survivin表达阳性,18例Survivin表达为阴性。15例复发病例中,12例为Survivin阳性,3例为Survivin阴性。复发病例中CK20异常表达和Survivin阳性表达均显著高于正常及阴性表达者(P<0.01,P<0.05)。【结论】CK20的异常表达和Survivin的阳性表达可以预测浅表性膀胱癌的复发高危性。     

RT-PCR检测尿液中细胞角蛋白20 mRNA与尿细胞学检查对膀胱癌诊断的荟萃分析

目的用荟萃(Meta)分析评价逆转录PCR(RT-PCR)技术检测尿液中细胞角蛋白(cytokeratin,CK)20 mRNA和尿细胞学检查对膀胱癌的诊断意义。方法检索Pub Med、Web of Science、The Cochrane Library(2014年第1期)、EMbase、CNKI、VIP、CBM数据库,查找关于用RT-PCR检测尿液中CK20 mRNA与尿细胞学检查诊断膀胱癌的研究。根据QUADAS质量评价标准评价纳入文献质量,用Meta-Disc 1.4软件进行荟萃分析。结果最终纳入11篇研究文献,涉及研究对象共1 631例。Meta分析结果显示,RT-PCR检测尿液中CK20 mRNA和尿细胞学检查诊断膀胱癌的敏感性、特异性、阳性似然比、阴性似然比汇总及95%CI分别是0.80(0.78,0.83)vs 0.53(0.49,0.56)、0.93(0.91,0.95)vs 0.90(0.88,0.93)、12.46(5.22,29.75)vs 6.04(3.37,10.84)、0.22(0.18,0.28)vs 0.51(0.42,0.63)。RT-PCR检测CK20 mRNA和尿细胞学检查诊断膀胱癌的敏感性随肿瘤分级、分期的升高而增高。两种检测方法的SROC曲线下面积分别是0.872 6和0.795 4,Q*指数分别是0.803 0和0.731 9。结论 RT-PCR检测尿液中CK20 mRNA诊断膀胱癌的敏感性高于尿细胞学检查,更适于膀胱癌的诊断。     

核基质蛋白22联合尿脱落细胞学检查诊断膀胱癌的价值探究

选取2013年1月~2015年12月我院收治的120例疑似膀胱癌患者。以术后病理确诊结果作为金标准,将患者分为阳性组107例和阴性组13例。采集患者的尿液标本,分别对患者进行核基质蛋白22检查、尿脱落细胞学检查,对比两组患者的核基质蛋白22含量,并计算核基质蛋白22、尿脱落细胞学检查以及联合检查对膀胱癌的诊断敏感性、特异性、准确性。与阴性组相比,阳性组患者的核基质蛋白22含量明显更高(P0.05)。核基质蛋白22联合尿脱落细胞学检查的诊断敏感性、特异性、准确性分别为98.13%、92.31%、97.50%,均明显高于核基质蛋白22、尿脱落细胞学检查(P0.05)。在膀胱癌的临床诊断中,采用核基质蛋白22联合尿脱落细胞学检查进行诊断,具有较高的诊断价值。     

尿液中核基质蛋白22联合端粒酶活性检测在膀胱癌诊断中的作用

目的探讨尿液中核基质蛋白22（NMP22）联合端粒酶活性检测在膀胱癌诊断中的价值。方法收集38例膀胱癌和28例非膀胱癌患者新鲜尿液,用化学发光分析法检测尿NMP22水平,TRAP—PCR-ELISA法检测尿脱落细胞端粒酶活性,并同时行尿脱落细胞学检查。结果尿液中NMP22对膀胱癌诊断的敏感性为79％,特异性为64％;端粒酶敏感性为82％,特异性为71％;细胞学检查敏感性为32％,特异性为97％。NMP22联合端粒酶活性检测,两者均为阳性时诊断为阳性,否则为阴性,则联合检测的敏感性为76％,特异性为89％。结论联合检测可使在维持较高敏感性的前提下,大大提高诊断的特异性,其特异性与细胞学检测相差较小,而敏感性却远高于细胞学检测,因而联合检测较单一指标的检测对膀胱癌具有更高的诊断价值。     

尿核基质蛋白-22测定在膀胱癌中的临床应用

目的:研究分析尿核基质蛋白-22测定在膀胱癌诊断中的应用价值。方法:随机抽取我院2015年9月~2016年3月收治的疑似膀胱癌患者50例作为研究对象,采用酶联免疫法对其尿样中的核基质蛋白-22水平进行测定,并行尿脱落细胞学检查,分别计算两种方法检查时患者的诊断阳性率。以患者的最终组织病理学诊断结果为依据,对核基质蛋白-22水平测定与尿脱落细胞学检查诊断膀胱癌的灵敏度、特异性、准确度进行计算,同时分析核基质蛋白-22水平与膀胱癌患者病理分级之间的相关性。结果:核基质蛋白-22水平测定、尿脱落细胞检查诊断膀胱癌的阳性率分别为66.00%和16.00%,检测灵敏度分别为86.67%、40.00%,特异性分别为42.86%、94.29%,准确度分别为56.00%、78.00%,核基质蛋白-22水平测定在检测阳性率、灵敏度上均显著高于尿脱落细胞检查,而检测特异性和准确度低于尿脱落细胞检查,差异均有统计学意义(P0.05)。在组织病理学检查确诊为膀胱癌的患者中,核基质蛋白-22检测水平随病理分级的升高而升高,且各级检测结果的比较差异均有统计学意义(P0.05)。结论:核基质蛋白-22测定应用于膀胱癌的筛查中,具有较高的灵敏度,且其检测水平与膀胱癌患者的病理分级之间存在显著相关性,可以将其作为膀胱癌的首选筛查方法,颇具临床应用价值。     

尿脱落细胞中生存素基因表达与膀胱肿瘤的关系

目的:通过检测尿脱落细胞中的生存素(survivin)表达水平,为膀胱癌的临床早期诊断、术后复发监测提供方便、快捷的方法。方法:收集尿脱落细胞、膀胱癌组织和正常膀胱内皮组织,提取其总RNA,采用逆转录-巢式聚合酶链反应(RT-PCR)检测生存素基因mRNA表达水平,同时采用免疫组化进行病理分级。结果:56例膀胱肿瘤患者,尿脱落细胞中生存素mRNA阳性率为96．4％,20例其他泌尿系疾病阳性率为5．0％,10名健康志愿者阴性。膀胱癌组织中生存素基因表达量在1、2、3级闻差异均有极显著意义(P<0．01)。结论:RT-PCR法检测生存素mRNA可以作为早期诊断、术后复发监测的指标。     

膀胱癌患者尿脱落细胞中survivin基因的检测

目的通过对膀胱癌患者尿液脱落细胞中人体细胞凋亡相关基因survivin的检测,探讨可早期发现、常规筛检膀胱癌,且不给患者带来痛苦的方法。方法留取31例膀胱癌患者、20例泌尿系其他良性疾病患者和10例健康志愿者的新鲜中段尿液200ml,用逆转录聚合酶链反应(RT-PCR)检测survivin的表达;同时行尿脱落细胞学检查。结果用RT-PCR检测尿液中survivin的敏感性为100%,与尿脱落细胞学检相比较,具有很高的敏感性。结论检测尿液中survivin可用于膀胱癌的术前诊断。     

Comparison of CD44 and cytokeratin 20 mRNA in voided urine samples as diagnostic tools for bladder cancer

ObjectivesWe evaluated the diagnostic efficacy of urinary CD44 and cytokeratin 20 (CK20) mRNA in comparison with voided urine cytology (VUC) for the detection of bladder cancer.Design and methodsA total of 136 Egyptian patients provided a single voided urine sample for CD44, CK20 mRNA and VUC before cystoscopy. Of the 136 cases, 111 were histologically diagnosed as bladder cancer whereas the remaining 25 had benign urological disorders. A group of 20 healthy volunteers was also included in this study. Voided urine was centrifuged and the urine sediment was used for cytology, estimation of CD44 by ELISA and RNA extraction. CK20 mRNA was detected by conventional RT-PCR and quantitative real-time RT-PCR.ResultsThe best cutoff values for CD44 and relative CK20 mRNA detected by real-time RT-PCR were calculated by receiver operating characteristic curve. The positivity rates and the mean ranks for CD44 and CK20 mRNA showed significant difference among the three investigated groups (p = 0.001). Quantitative real-time RT-PCR results were comparable to conventional RT-PCR for the detection of CK20 mRNA. The positivity rate of CD44 was significantly associated with schistosomiasis and urine cytology. The overall sensitivity and specificity were 52.3% and 88.9% for VUC, 63.1% and 88.9% for CD44, and 82.0% and 97.8% for CK20 mRNA. Combined sensitivity of VUC with CD44 and CK20 mRNA together (95.5%) was higher than either the combined sensitivity of VUC with CD44 (78.4%) or with CK20 mRNA (91.0%) or than that of the biomarker alone.ConclusionUrinary CD44 and CK20 mRNA had higher sensitivities compared to VUC. However, when the diagnostic efficacy was considered, CK20 mRNA by either conventional RT-PCR or real-time RT-PCR had the highest sensitivity and specificity compared to CD44 and VUC.     

核基质蛋白22、细胞角质素20和存活素mRNA对膀胱癌诊断价值的研究

目的探讨核基质蛋白22(NMP22)、细胞角质素20(CK20)和存活素mRNA在膀胱癌诊断中临床应用价值。方法选择因血尿和膀胱刺激症状到该院泌尿外科诊治的患者107例,分为对照组(44例)和观察组(63例)。观察组中按照肿瘤TNM分期和WHO分级,包括T1s~T1 44例,T2~T4 19例;G1 14例,G2 31例,G3 18例;另外选择45例健康志愿者作为健康组。通过ELISA方法检测所有志愿者尿液中NMP22水平,通过RT-PCR方法检测对照组和观察组受试者尿液中CK20和存活素mRNA表达量,比较这3种检测方法的灵敏度和特异度,以评估对膀胱癌诊断的价值。结果观察组患者尿液中NMP22的水平(37.92U/mL)显著高于健康组(4.31U/mL)和对照组(7.04U/mL),差异有统计学意义(P0.05)。NMP22检测指标的灵敏度和特异度分别为82.54%和61.36%,与肿瘤分期和分级无明显相关性;CK20和存活素mRNA检测指标的灵敏度和特异度分别为83.70%、63.64%和85.71%、90.91%,与肿瘤分期有显著的相关性;T2~T4亚组患者CK20和存活素mRNA检测灵敏度高于T1s~T1亚组患者,差异具有统计学意义(P0.05)。结论尿液NMP22、CK20和存活素mRNA检测对膀胱癌的诊断均有较高的灵敏度和特异度,是诊断膀胱癌较好的无创性手段。     

联合检测尿膀胱癌抗原和survivin诊断膀胱癌的临床应用

目的临床评价联合检测尿液中尿膀胱癌抗原（urinary bladder cancer antigen,UBC）和survivin基因诊断膀胱癌的临床应用价值。方法对64例膀胱癌患者、20例泌尿系其他良性疾病患者,在膀胱镜检查之前留尿将尿样分为3份,分别进行UBC、survivin和脱落细胞检测,分析比较三种方法诊断膀胱癌的临床应用价值。结果 UBC和survivin诊断膀胱癌的敏感度分别为85.9%（55/64）和93.8%（60/64）,与脱落细胞学（40.6%）比较,差异有统计学意义（P〈0.01〉,三种方法诊断膀胱癌的特异度分别为85.0%（17/20）、95%（19/20）和95%（19/20）。各分级和分期UBC和survivin诊断膀胱癌的敏感度均高于尿脱落细胞学检查;UBC值和survivin检测的敏感度在各分级和分期中差异无统计学意义（P〉0.05）;而尿脱落细胞学检查,肿瘤的分级越高,其敏感度越高（P〈0.01）,各分期之间差异无统计学意义（P〉0.05）。联合运用UBC和survivin,敏感度和特异度均达到100%。结论尿液中的UBC和survivin是早期诊断膀胱癌较好的肿瘤标志物,联合检测能提高诊断的敏感度和特异度。     

尿Survivin mRNA检查对膀胱移行细胞癌的诊断价值

目的探讨检测尿Survivin mRNA诊断膀胱移行细胞癌（TCC）的临床价值。方法采用半定量逆转录-聚合酶链反应法（PT-PCR）对30例TCC患者、30例对照组（泌尿系统非肿瘤患者）尿脱落细胞Survivin mRNA进行检测。结果30例TCC患者尿脱落细胞中均检测出Survivin mRNA表达,而对照组中仅1例尿脱落细胞中检测出Survivin mRNA表达。病例组与对照组Survivin mRNA表达阳性率差异有统计学意义（P〈0．01）。以RT-PCR检测TCC患者尿脱落细胞中Survivin mRNA的方法敏感性为100％,特异性为96．7％。结论检测尿脱落细胞中Survivin mRNA的表达可作为早期诊断TCC的敏感性指标。     

Comparison of cytokeratin 20 RNA and angiogenin in voided urine samples as diagnostic tools for bladder carcinoma

BACKGROUND: We evaluated the diagnostic efficacy of urinary angiogenin (ANG) and cytokeratin 20 (CK-20) mRNA in comparison with voided urine cytology in the detection of bladder cancer patients. OBJECTIVES AND METHODS: A total of 97 Egyptian patients provided a single voided urine sample for ANG, CK-20 and cytology before cystoscopy. Of the 97 cases, 63 were histologically diagnosed as bladder cancer; 33 with transitional cell carcinoma (TCC) and 30 with squamous cell carcinoma (SCC), whereas the remaining 34 had benign urological disorders. A group of 46 healthy volunteers were also included in this study. Voided urine was centrifuged and the supernatant was used for estimation of ANG by EIA and confirmed by Western blotting (WB). The urine sediment was used for cytology and RNA extraction. CK-20 RNA was detected by RT-PCR. RESULTS: The best cutoff value for ANG was calculated by a ROC curve as 322.7 ng/mg protein. The median urinary ANG level in bladder carcinoma, benign urological disorders and healthy volunteer groups was: 802.7, 425 and 33 pg/mg protein, respectively. The positivity rate for urinary CK-20 mRNA of the control, benign and malignant groups was 0%, 2.9% and 82.3%, respectively (P = 0.000); while the rates for ANG were 11.6%, 54.8% and 75.4%, respectively (P = 0.000). There was no significant difference in positivity rates of CK-20 and ANG with respect to sex, smoking, schistosomiasis, urine cytology, tumor grade, tumor stage, hematuria or pus cells. The overall sensitivity and specificity were 71.4% and 90% for voided urine cytology, 75.4% and 70.3% for ANG, and 82.3% and 98.8% for CK-20. Combined sensitivity of voided urine cytology with ANG and CK-20 together (98.2%) was higher than either the combined sensitivity of voided urine cytology with ANG (96.5%) or with CK-20 (91.6%) or than that of the biomarker alone. We demonstrated significant positive correlation between CK-20 positivity with age (P = 0.043) and nodal involvement (P = 0.037); however, there was no significant correlation between CK-20 and ANG with the other clinicopathological parameters. CONCLUSIONS: Our data indicate that CK-20 and ANG in voided urine had higher sensitivities compared to voided urine cytology. However, when specificity was considered, CK-20 alone had superior sensitivity and specificity compared to ANG and voided urine cytology.     

Performance characteristics of multiple urinary tumor markers and sample collection techniques in the detection of transitional cell carcinoma of the bladder

BACKGROUND: The optimal management of bladder cancer requires early detection of both primary tumor as well as recurrences. This study compared the methodologies of the following tumor markers and diagnostic tools: telomerase, bladder tumor-associated analytes (BTA stat), nuclear matrix protein 22 (NMP22), the hemoglobin (Hb) dipstick and chemiluminometric red cell assays, and determined their respective sensitivity and specificity in detection of bladder cancer along with urine cytology. METHODS: Different sample collection techniques were used including bladder tissue from radical cystectomy or transurethral resection, voided and cystoscopically collected urine and bladder washes. Results of these techniques were compared for some of these markers. RESULTS: The first study utilizing cystoscopically collected urine and bladder washes, the sensitivity of telomerase in detecting bladder cancer was 92% and 87%, respectively, whereas for bladder tissue it was 93%. The sensitivities of cytology, NMP22 and original BTA, however, were 62%, 54% and 49%, respectively. In the second study using first single voided urine from patients with bladder cancer and non-bladder cancer controls, the greatest sensitivity (overall 77%) and specificity (overall 98%) was exhibited with telomerase. The combined sensitivity of telomerase with that of either the hemoglobin dipstick or chemiluminometric red cell assays, showed that the overall sensitivity was increased to 89% and specificity to 98%. CONCLUSIONS: The sensitivity and specificity of telomerase activity in conjunction with chemiluminometric red cell or hemoglobin dipstick assay may be considered as an alternative to urinary cytology. It can also supplement cystoscopy for monitoring recurrence of bladder cancer.     

Bladder tumor antigen assay as compared to voided urine cytology in the diagnosis of bladder cancer

BACKGROUND: The study was aimed at comparing the diagnostic accuracy of the quantitative bladder tumor antigen (BTA) TRAK immunoassay with exfoliative urine cytology in the detection of primary and recurrent bladder cancer. METHODS: The analysis was carried out on 194 high risk patients undergoing a diagnostic cystoscopy, 279 patients with previous history of transitional cell carcinoma awaiting a follow-up cystoscopy, and 45 healthy controls. Urine cytology was performed by a skilled cytopathologist on three consecutive samples. RESULTS: BTA TRAK values resulted significantly higher in tumor positive cases than in absence of bladder tumor for both groups of patients. Non neoplastic urothelial diseases as well as the absence of mucosal abnormalities were associated with a marked increase in BTA TRAK levels with respect to the control group. Overall sensitivity and specificity was 63 and 63% for BTA TRAK (cut-off 34 U/ml), and 68.3 and 73.4% for urine cytology, respectively. The diagnostic advantage of urine cytology was maintained when patients were stratified by tumor grade. CONCLUSIONS: The clinical performance of the BTA TRAK in the detection of primary or recurrent bladder cancer is acceptable and reproducible as shown by similar results with previous reports, although urine cytology performed on three samples showed the highest sensitivity and specificity.     

膀胱移行细胞癌患者尿Survivin及透明质酸含量检测意义

目的:探讨尿survivin含量及尿液透明质酸含量检测在膀胱癌诊断及预后中的价值。方法:本实验观察对象为膀胱癌患者87例、其他疾病患者40例及30例健康成人。收集各组尿液,采用ELISA法行survivin、透明质酸含量检测。结果:膀胱癌组survivin含量为(2.51±1.91)μg/L,其他疾病组为(0.55±0.22)μg/L,正常对照组(0.40±0.17)μg/L。膀胱癌组尿液透明质酸含量为(3.12±0.69)mmol/L,其他疾病组为(1.41±0.46)mmol/L,正常对照组为(1.24±0.35)mmol/L。结论:联合检测尿survivin含量和透明质酸含量可作为膀胱癌无创诊断及预后判断辅助方法。