肾盂尿路上皮癌患者尿NMP22、TPS、CYFRA21-1、CA19-9的检测与评估  

Evaluation of NMP22,TPS,CYFRA21-1 and CA19-9 in the urine of patients for the diagnosis of urothelial carcinoma of renal pelvis

作　　者：李志斌[1] 陈惠庆[1] 米振国[1] 宋继文[1] 韩雪冰[1] 韩存芝[2] 

机构地区：[1]山西省肿瘤医院泌尿外科,太原030013 [2]山西省肿瘤医院病因室,太原030013

出　　处：《现代泌尿生殖肿瘤杂志》2016年第4期204-211,共8页Journal of Contemporary Urologic and Reproductive Oncology

摘　　要：目的探讨尿液核基质蛋白22（nuclear matrix protein 22,NMP22）、组织多肽特异性抗原（tissue polypeptide-specific antigen,TPS）、CYFRA21-1、糖链蛋白19-9（carbohydrate antigen 19-9,CA19-9）对肾盂尿路上皮癌的诊断价值。方法回顾性分析山西省肿瘤医院2010年1月至2015年12月检测的至少两种上述尿液肿瘤标志物的患者资料,共218人次,包括肾盂尿路上皮癌63例（A组）、膀胱尿路上皮癌46例（B组）、非尿路上皮肿瘤的泌尿系其他疾病62例（C组）、A组行根治术后2年未复发47例（D组）,另有健康志愿者20例（E组）。比较各组尿NMP22、TPS、CYFRA21-1、CA19-9表达水平,并绘制受试者工作特征（receiver operating characteristic,ROC）曲线,计算ROC曲线下面积。结果 A组NMP22水平高于B组,差异有统计学意义（P=0.001）。A组与B组的TPS、CYFRA21-1、CA19-9水平差异无统计学意义（P〉0.05）。A组和B组的TPS、NMP22、CYFRA21-1、CA19-9水平均高于C组、D组、E组,差异有统计学意义（P〈0.05）。C组、D组及E组的NMP22、TPS、CYFRA21-1、CA19-9水平差异无统计学意义（P〉0.05）。A组中NMP22、TPS、CYFRA21-1、CA19-9水平在不同病理分级、临床分期、肿瘤大小、是否肾积水等的差异无统计学意义（P〉0.05）。A组NMP22、TPS、CYFRA21-1、CA19-9的诊断准确率高于尿脱落细胞学检查,差异有统计学意义（P〈0.05）。四种肿瘤标志物的ROC曲线下面积为0.7~0.9,诊断效能中等,最高者为NMP22与CYFRA21-1的组合,为0.884。结论尿液NMP22、TPS、CYFRA21-1、CA19-9对肾盂尿路上皮癌的诊断有帮助,诊断效能中等,但它们对肾盂癌肿瘤分期和病理分级的预测、术后监测、预后判断等方面的作用有待进一步研究。Objective To study the diagonsis value of urinary tissue polypeptide-specific antigen（TPS）,nuclear matrix protein 22（NMP22）,CYFRA21-1and carbohydrate antigen 19-9（CA19-9）in urothelial carcinoma of renal pelvis. Methods The study was a retrospective analysis with clinical data of cases of urothelial carcinoma of renal pelvis in Shanxi Provincial Tumor Hospital from 2010 January to 2015 December,including 238 urine samples from 63 cases with urothelial carcinoma of the renal pelvis（group A）,46 cases with urothelial carcinoma of the urinary bladder（group B）,62 cases with other urological diseases（group C）,47 cases with no recurrence after radical resection from the renal pelvis group for at least 2years（group D）,20 volunteers from our hospital（group E）.Voided urine samples were collected before cystoscopies or surgeries.NMP22,TPS,CYFRA21-1,CA19-9 were measured by chemiluminescent immunoassays.We evaluated their concentration of urine and draw receiver operating characteristic cutoffs curves,and calulated the areas under the ROC curves for further statistical analysis.Results The urine concentration of NMP22 in group A was higher than that in group B,the difference was statistically significant（P=0.001）.Therewas no significant difference in the urine concentrations of TPS,CYFRA21-1and CA19-9between group A and group B（P〈0.05）.The urine concentrations of CA19-9,NMP22,CYFRA21-1and TPS in group A were higher than that in group C,group D and group E,and the differences were statistically significant（P〈0.05）.The urine concentrations of NMP22,TPS,CYFRA21-1and CA19-9in group B were higher than those in group C,group D and group E,and there were significant differences（P〈0.05）.There was no significant difference in the urine concentrations of NMP22,TPS,CYFRA21-1and CA19-9among the group C,group D and group E（P〈0.05）.The urine concentrations of NMP22,TPS,CYFRA21-1,CA19-9in the group A were not statistically significant（P〈0.05）between group of different patholog

关 键 词：上尿路尿路上皮癌 肾盂 核基质蛋白22 组织多肽特异性抗原 CYFRA21-1 糖链蛋白19-9 

分 类 号：R737.1[医药卫生—肿瘤]