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.

The clinical value of combined use of the urinary bladder cancer antigen and survivin in detecting of bladder cancer

Objective To study the clinical value of combining urinary bladder cancer antigen (UBC) and survivin in urine for detecting bladder cancer.Methods 64 bladder cancer patients, 20 urological benign disease patients were enrolled in the study and the urine UBC and survivin were determined by enzyme-linked immunosorbent assay (ELISA), and conventional RT-PCR before cystoscopy. Results The sensitivity of UBC (85.9%) and survivin (93.8%) were significantly higher than urinary cytology (40.6%). The specificity of UBC, survivin and urinary cytology was 85.0%, 93.4% and 95%, respectively. The sensitivity of UBC, and survivin were significantly higher than urinary cytology in different pathologic state and histologic grade(P<0.01, respectively). The sensitivity of UBC had no significant difference in different histologic stages and grades(P>0.05). No difference was observed in different histologic stages and grades for survivin test (P>0.05, respectively). However, with higher histologic grade, the sensitivity of cytology was improved (P<0.01). There was no difference in different histologic stages for cytology(P>0.05). Combined use of UBC and survivin, both the sensitivity and specificity were arrived 100% respectively. Conclusions The UBC and survivin were sensitive, specificity, simple, feasible and noninvasive diagnostic marker for the early detection of urinary bladder cancer and combined use of them can improve the sensitivity and specificity.