核基质蛋白22及尿膀胱癌抗原在膀胱移行细胞癌诊断中的价值

目的 探讨核基质蛋白22(NMP22)及尿膀胱癌抗原(UBC)的检测用于早期诊断膀胱移行细胞癌(BTCC)的可行性及影响因素.方法 膀胱移行细胞癌患者60例,泌尿系良性疾病患者25例,健康对照组20名,采用酶联免疫(ELISA)方法检测尿NMP22及UBC.膀胱镜检查前取尿样分别进行NMP22、UBC和脱落细胞学检测,分析比较3种方法的敏感性、特异性、阳性和阴性预测价值.结果 以大于正常对照组尿液NMP22水平上限10 U/ml为NMP22阳性界值,以12μg/L为UBC诊断膀胱移行细胞癌的临界值时,NMP22和UBC诊断膀胱移行细胞癌的敏感性分别为88.3%和86.7%,与脱落细胞学(40.0%)比较,差异均有统计学意义(P均<0.01),3种方法诊断膀胱移行细胞癌的特异性分别为80.0%、84.0%和92.0%,阳性预测值分别为91.4%、92.9%和92.3%,阴性预测值分别为74.1%、72.4%和38.9%.结论 尿NMP22和UBC检测技术简单,有较高的敏感性和特异性,可作为早期诊断膀胱移行细胞癌的肿瘤标记物.

The clinical value of measurement of urine nuclear matrix protein 22 and urinary bladder cancer antigen content in patients of bladder transitional cell carcinoma

Objective To assess the feasibility of nuclear matrix protein 22(NMP22)and urinary bladder cancer,antigen (UBC) for the early diagnosis of bladder transitional cell carcinoma and its influencing factors.Methotis 105 subjects,including 60 patients of bladder cancer,25 patients of urological benign disease and 20 normal (healthy)individuals were enrolled in this study.Urine NMP22 and UBC wag assessed by enzyme-linked immunosorbent assay(ELISA).Urine NMP22 and UBC as well as exfoliocytology were conducted for the purpose to compare the sensitivity,specificity,positive and negative predictive value of these three ways.Results The sensitivity of NMP22(88.3%)and UBC(86.7%)were significantly better than exfolioeytology(40.0%,P<0.01).The specificity of NMP22,UBC and exfoliocytology were 80.0%,84.0%and 92.0%,respectively, the positive predictive values were 91.4%,92.9%and 92.3%,and the negative predictive values were 74.1%.72.4%and 38.9%.Conclusions NMP22 and UBC are sensitive,specific,simple,feasible and noninvasive diagnostic markers for the early detection of urinary bladder transitional cell cancer.