联合检测尿液中CYFRA21-1及端粒酶活性在膀胱癌早期诊断中的意义  

Combined detection of CYFRA21-1 and telomerase activity in urine for early diagnosis of bladder carcinoma

作　　者：李刚[1] 付成[1] 

机构地区：[1]辽宁省肿瘤医院泌尿外科,沈阳110042

出　　处：《实用肿瘤学杂志》2008年第5期417-419,共3页Practical Oncology Journal

基　　金：辽宁省自然科学基金资助项目(99305006)

摘　　要：目的通过联合检测尿液中细胞角蛋白19(CYFRA21-1)及端粒酶活性在膀胱癌患者中的水平,探讨其在膀胱癌术后复发早期诊断中的意义。方法运用双单抗夹心酶联免疫法(ELISA)检测110例膀胱癌患者,52例良性患者及30名健康志愿者尿液样品中CYFRA21-1含量,以3.3ng/mL检测临界值;采用聚合酶链反应的酶联免疫吸附试验(PCR-ELISA)方法检测以上三组尿液样品中端粒酶活性。结果膀胱癌患者尿液中CYFRA21-1水平显著高于良性患者组和正常对照组(P(0.01)。与膀胱癌分期分级的相关性分析显示浸润性膀胱癌(T2、T3、T4)CYFRA21-1水平均高于表浅性膀胱癌(Tis、Ta、T1),相比有统计学意义(P(0.05)。CYFRA21-1水平、端粒酶活性检测诊断膀胱癌的敏感度分别为92.2%、78.2%,特异度为66.7%、93.3%;而将上述方法联合应用来筛检则敏感性可达到97.5%。结论联合应用CYFRA21-1及端粒酶的检测敏感性高,特异性好,可用于膀胱癌的早期诊断及术后随访。Objective To evaluate the value of cytokeratin 19 fragment （CYFRA21-1）and telomerase activity in urine for early diagnosis of bladder carcinoma. Methods CYFRA21-1 were detected by means of ELISA technique in 110 eases of bladder carcinoma, 52 cases of benign patients and 30 cases of normal subjects. Telomerase activity were detected by means of PCR-ELISA technique in above cases. Results Urine CYFRA21- 1 level of bladder carcinoma were significantly higher than those in normal subjects and in benign patients （P 〈0.01 ）, correlation analysis demonstrate that the level of urine CYFRA21-1 were positively correlated to clinical stage, urine CYFRA21-1 level in patients with local advanced- stage tumors（ T2,T3 ,T4）were significantly higher than those with superficial tumor（Tis,Ta,T1 ）. The Sensitivity is 92.2% and 78.3% for urine CYFRA21- 1 and telomerase in diagnosis of bladder carcinoma, respectively, specificity is 66.7 % and 93.3 %, respectively. The combined assay of urine CYFRA21-1 and telomerase could raise sensitivity to 97.5%. Conclusions The combination of 2 tumor markers, CYFRA21-1 and telomerase, is more sensitive and specific than single, therefore, could be useful in screening and follow up for bladder cancer.

关 键 词：CYFRA21—1 端粒酶 早期诊断 膀胱癌 

分 类 号：R737.14[医药卫生—肿瘤]