膀胱癌根治术后复发监测中尿肿瘤标志物联合检测组合方式的研究

目的探讨膀胱癌根治术后复发监测中尿肿瘤标志物联合检测的最佳组合方式。方法对40例膀胱癌根治术患者于术后复发监测中进行尿纤维连接蛋白（FN）、核基质蛋白22（NMP-22）、膀胱肿瘤抗原（BTA）、纤维蛋白降解产物（FDP）、透明质酸酶（HA）等5项肿瘤标志物检测,然后按二联、三联组合方式计算其不同组合方式检测的灵敏度、特异度和准确度,并进行比较。结果 （1）联合检测时其灵敏度均较单项检测时提高,差异均有统计学意义,均P〈0.05;联合检测时其特异度降低,但差异均无统计学意义,均P〉0.05;联合检测时其准确率均有所提高,但差异均无统计学意义,均P〉0.05。（2）二联组合方式中以FN＋NMP-22组合灵敏度最高,其次为FN＋BTA、NMP-22＋BTA组合,与其他组合比较差异有统计学意义,均P〈0.05。各种二联组合之间的特异度、准确率的差异均无统计学意义,均P〉0.05。（3）三联组合方式中以FN＋NMP-22＋BTA组合灵敏度最高,与其他组合比较差异有统计学意义,均P〈0.05;各种三联组合之间的特异度、准确率的差异均无统计学意义,均P〉0.05。结论尿肿瘤标志物联合检测可望部分替代膀胱镜检查用于膀胱癌根治术后复发监测,而且在决定尿肿瘤标志物联合检测的组合方式时应尽量选择FN及NMP-22。

Research of combination of urinary tumor markers in the monitoring of recurrence after radical mastectomy of bladder cancer

Objective To investigate the best combination of urinary tumor markers in the monitoring of recurrence after radical mastectomy of bladder cancer. Methods Forty cases of bladder cancer patients with radical mastectomy were detected by urinary fibronectin （FN）, nuclear matrix protein 22 （NMP-22）, bladder tumor antigen （BTA）, fibrin degradation products （FDP） and hyaluronidase （HA）. Then press the combination of the two markers and three markers, and to calculate the sensitivity, specificity and accuracy of the different combinations and the difference between each combination were compared. Results （1）The sensitivity of joint detection than the sensitivity of individual detection were increased. The differences had statistically significant, all P 0.05. The specificity of joint detection than the specificity of individual detection were lowered. But the differences had not statistically significant, all P 0.05. The accuracy of joint detection than the accuracy of individual detection were increased. But the differences had not statistically significant, all P 0.05. （2）In the bivalent combinations, the sensitivity of FN＋NMP-22 combination was highest, followed by the FN ＋ BTA combination and NMP-22＋BTA combination. Compared with the other combinations, the differences had statistically significant, all P 0.05. Between various bivalent combinations, specificity and accuracy showed no significant difference, all P 0.05. （3）In the triple combination, the sensitivity of FN＋NMP-22＋BTA combination was highest. Compared with the other combinations, the differences had statistically significant, all P 0.05. Between various triple combinations, specificity and accuracy showed no significant difference, all P 0.05. Conclusion Joint detection of urinary tumor markers are expected to partially replace cystoscopy for bladder cancer after radical resection of recurrence monitoring, and try to determine the composition of the joint detection of urinary tumor markers should be FN and NMP-22.