尿液NMP22 UBC及BTA联合检测在膀胱癌早期诊断中的意义研究  

The Detecting Significance of NMP22,UBC and BTA in the early Diagnosis of Bladder Cancer

作　　者：李扬 林章礼 郑衍平 许瑞明 张敬成[3] 卢小卓[4] 

机构地区：[1]广东省汕头市中医医院,广东汕头515031 [2]广东省汕头市第二人民医院,广东汕头515031 [3]汕头大学医学院第一附属医院,广东汕头515041 [4]暨南大学第四附属医院,广东广州510220

出　　处：《河北医学》2008年第11期1261-1264,共4页Hebei Medicine

基　　金：广东省医学科研基金专项课题(A2006648)

摘　　要：目的:评价膀胱癌抗原核基质蛋白22、尿膀胱癌抗原、膀胱肿瘤抗原在诊断膀胱癌中的应用价值。方法:应用酶联免疫吸附试验(ELISA)检测膀胱癌疑似尿中NMP22、UBC、BTA的浓度,并与正常组进行对比,评价NMP22、UBC、BTA在诊断时的价值。结果:膀胱癌患者的NMP22、UBC、BTA含量与正常组比较差异均有显著性(P<0.01)。当NMP22的临床判断值为10.0 U/ml时,NMP22检测敏感性76.5%(26/34),特异性72%(18/25),阳性预测值为78.8%,阴性预测值为69.2%;UBC临床判断值为12μg/L时,检测敏感性67.5%(23/34),特异性76%(19/25),阳性预测值为79.3%,阴性预测值为63.3%;BTA临床判断值为11.2U/L时,检查敏感性73.5%(25/34),特异性64%(16/25),阳性预测值为73.5%,阴性预测值为64%。NMP22和BTA敏感性和阳性预测值显著高于UBC,NMP22和BTA敏感性和阳性预测值差异不显著。UBC和NMP22特异性显著高于BTA,NMP22阴性预测值显著高于UBC和BTA。3种肿瘤标志物联合检测敏感性97.1%(33/34),特异性为80%(20/25),阳性预测值为86.8%,阴性预测值为95.2%。联合检测的敏感性、特异性、阳性预测值、阴性预测值显著高于任何单一肿瘤标志物检测。对于膀胱癌不同分级和分期,NMP22、UBC含量和阳性率随着膀胱移行细胞癌分期、分级的升高而显著增加,BTA含量和阳性率在各分级和分期之间差别无显著性意义。结论:尿中NMP22、UBC、BTA检测可用于膀胱癌的诊断,三者联合应用对膀胱癌的诊断价值优于单独检测。Objective： To evaluate the clinical value of NMP22, UBC and BTA in the early diagnosis of bladder cancer. Methods： Enzyme-linked immunosorbent assay was used to detect th.e concentration of NMP22, UBC and BTA in the urine in suspected patients, and the concentration were compared with that in the normal people. Results：The concentration of NMP22, UBC and BTA in urine in people with bladder cancer were significantly higher than that in normal people. When the clinical value for NMP22 was 10.0 U/ ml, the sensitivity was 76.5%, the specificity was 72%, the positive prediction was 78.8% , the negative prediction was 69.2% ; When the clinical value for UBC was 12μg/L, the sensitivity was 67.5% ; the specificity was 76% , the positive prediction was 79.3%, the negative prediction was 63.3% ; When the clinical value for BTA was 11. 2U/L, the sensitivity was 73. 5%, the specificity was 64% , the positive pre diction was 73. 5%, the negative prediction was 64%. The sensitivity and specificity of NMP22 and BTA were significantly higher than that of BTA; the specificity of UBC and BTA were significantly higher than BTA. while the negative prediction of NMP22 was significandy higher than that of UBC and BTA. The sensitivity , specialty, positive prediction and negative prediction in the combined detection of NMP22, UBC and BTA were significandy higher that in any single detection, they were 97.1% , 80%, 86.8% , 95.2% , respectively. The concentration of NMP22 and UBC improved with the rise of grade and stage of bladder transitional cell carcinoma, while the concentration of BTA didn＇ t differ according grade and stage. Conclusions： NMP22, UBC and BTA could be used to diagnose bladder cancer, and the combined detection is better than any single detection.

关 键 词：核基质蛋白22 尿膀胱癌抗原 膀胱肿瘤抗原 膀胱癌 

分 类 号：R737.14[医药卫生—肿瘤]