尿纤维连接蛋白试纸诊断膀胱尿路上皮癌的价值

目的 研究尿纤维连接蛋白试纸（FN试纸）诊断膀胱尿路上皮癌的灵敏度和特异度,探讨其与膀胱尿路上皮癌各项临床指标之间的关系,为进一步无创性地诊断、随访膀胱尿路上皮癌提供依据.方法 运用自主研制的FN试纸测定膀胱尿路上皮癌患者、良性泌尿系疾病患者、正常体检人群尿液纤维连接蛋白.结果 FN试纸诊断膀胱尿路上皮癌的敏感度和特异度分别为72.94%和79.03%,其阳性预测值和阴性预测值分别为85.67%和68.06%;尿液细胞学诊断膀胱尿路上皮癌的特异度较高（100%）,但其敏感度仅为47.06%.结论 FN试纸检测对不同分化及浸润深度的膀胱尿路上皮癌有着较高的灵敏度与特异度,诊断价值高于尿液液基细胞学检查,但不能对膀胱肿瘤的分级以及病灶数量进行检测.

Diagnosis of urothelial carcinoma of bladder by test paper of urinary fibronectin

Objective To evaluate the diagnostic efficacy of fibronectin in the urine samples of patients with urothelial carcinoma （UC） of bladder by urinary fibronectin test paper. Methods This study included 147 subjects： one group （Group A） of 85 patients with UC confirmed by pathol- ogy; a second group （Group B） of 12 patients with benign urologic disease, 7 of them were benign prostate hyperplasia, the others were urolithiasis; a third group （Group C） of 50 normal health ex- amination subjects confirmed by cystoscopy. We carried out the analysis of urinary fibronectin （UF） test and cytology preoperatively or before the medical therapy. For the determination of UF, we used a UF test paper to test the morning urine sample. Results The sensitivity and specificity of the UF test paper for the diagnosis of bladder cancer was 72.940% and 79.03 %, respectively. The positive predic- tive value and negative predictive value of the UF test paper was 85. 67%and 68. 06% respectively. Though the urinary cytology resulted in a higher specificity （100%）, the sensitivity was much lower （47.06%. Conclusions UF test paper has a high specificity of 72.94% and sensitivity of 79.03%in the diagnosis of UC with variant differentiation and invasion, and its diagnosis value is higher than cytology, but it cannot predict the grade and number of bladder cancer.