膀胱癌新标志物UPK3A的临床应用研究  

The clinical research of new bladder cancer marker UPK3A

作　　者：来永庆[1] 孟作为[1] 陶令之[1] 

机构地区：[1]北京大学深圳医院泌尿外科,518036

出　　处：《现代泌尿生殖肿瘤杂志》2010年第4期232-236,共5页Journal of Contemporary Urologic and Reproductive Oncology

基　　金：深圳科学技术项目课题资助(200903079)

摘　　要：目的前瞻性评价人Uroplakin 3A(UPK3A)诊断膀胱癌的作用,探索更好的非侵入性的诊断膀胱癌的方法。方法收集34例健康志愿者、46例良性泌尿外科疾病患者和112例膀胱癌患者的尿液。酶联免疫吸附试验定量检测尿液中UPK3A水平,核基质蛋白22(NMP22)检测试剂盒测定NMP22,同时进行尿脱落细胞学检测。结果膀胱癌患者尿液UPK3A水平明显高于健康志愿者和良性泌尿外科疾病患者,差异有统计学意义(P<0.01)。UPK3A的受试者工作特征(ROC)曲线显示了一个0.911的良好曲线下面积。以OD0.0685作为临界值可以获得一个较适宜的敏感度(83%)和特异度(84%)的组合。UPK3A、NMP22和尿脱落细胞学诊断膀胱癌的敏感度分别为83%、58%和64%;特异度分别为84%、75%和82%。结论膀胱癌患者尿液UPK3A水平较高,UPK3A可作为诊断膀胱癌的一个敏感的标志物,但还需要大规模的多中心研究进行验证。Objective Current methods for reliable detection of bladder cancer have some limitations.Finding better noninvasive methods for detection of bladder cancer is an important topic in urology.We want to evaluate prospectively the early detection power of Human Uroplakin 3A（UPK3A） for bladder cancer.Methods Urine samples were obtained from 34 healthy volunteers,46 patients with benign urologic disorders and 112 patients with bladder cancer.The urine UPK3A levels were quantified by enzyme-linked immunosorbent assay.All the samples were also tested with NMP22 test and cytology examination.Results The urinary UPK3A levels are uniformly elevated in bladder cancer patients than those of normal volunteers and patients with benign urologic disorders and the differences in the mean urinary UPK3A levels of bladder cancer patients and those of normal individuals or benign urologic disorders are statistically significant（P〈0.01）.The ROC curve of UPK3A showed an excellent area under the receiver operating characteristic curve of 0.911.In this study,the optimal combination of sensitivity and specificity were determined as 83% and 84% for a cut-off value of OD 0.0685,respectively.The sensitivity of urine UPK3A,NMP22 and cytology for detecting bladder cancer were 83%,58% and 64%,respectively,whereas specificity was 84%,75%,and 82%,respectively.Conclusions It is concluded that individuals with bladder cancer have higher UPK3A values.Our data suggest that urine measurement of UPK3A is a sensitive marker for the detection of bladder cancer.However,it needs further studies in larger cohorts.

关 键 词：膀胱肿瘤 生物学标记 UPK3A 

分 类 号：R737.14[医药卫生—肿瘤]