尿液膀胱癌特异性核基质蛋白4检测对非肌层浸润性膀胱癌术后监测及预后评估的意义  

Significance of urine BLCA-4 immunoassay in the postoperative surveillance and prognosis evaluation of non-muscle invasive bladder cancer

作　　者：邓楠[1] 钟剑峰[1] 黄伟佳[1] 刘平[1] 高兴成[1] 

机构地区：[1]广州医科大学附属第三医院泌尿外科,广州510150

出　　处：《中华生物医学工程杂志》2017年第2期134-138,共5页Chinese Journal of Biomedical Engineering

基　　金：广东省医学科学技术研究基金面上项目（WSTJJ20131230441402197204292033）

摘　　要：目的 探讨尿液膀胱癌特异性核基质蛋白4（BLCA-4）检测对非肌层浸润性膀胱尿路上皮癌术后监测及预后评估的意义.方法 收集2013年12月至2015年6月就诊于本科室的膀胱癌患者42例,均行经尿道膀胱肿瘤电切术,术后均经病理证实为膀胱非肌层浸润性尿路上皮癌.术前及术后1、3、6、12个月收集患者尿液标本进行BLCA-4水平检测,术后每月进行膀胱镜检查明确肿瘤复发情况.分析术前尿液BLCA-4水平与临床病理参数的关系.多因素COX回归分析膀胱癌术后复发的危险因素.结果 42例患者尿液BLCA-4水平在术后1个月降至最低,术后3个月开始逐渐升高.术后肿瘤复发患者经膀胱镜检查确诊前均出现尿液BLCA-4水平升高,尿液BLCA-4呈阳性最早时间比膀胱镜确诊复发时间早（8.1＆#177;3.5）个月.术前尿液BLCA-4水平与肿瘤分级、临床分期有关（均P〈0.05）.多因素COX回归分析显示,术前尿液BLCA-4高表达、术后3个月及6个月尿液BLCA-4阳性是肿瘤复发的危险因素（均P〈0.05）.结论 检测尿液BLCA-4水平适用于膀胱癌术后监测及预后判断.Objective To investigate the significance of urine bladder cancer specific nuclear matrix protein 4（BLCA-4）immunoassay in postoperative surveillance and prognosis evaluation of non-muscle invasive bladder cancer（NMIBC）. Methods From December 2013 to June 2015,42 patients with bladder cancer registered in our department underwent transurethral electrocision of the bladder cancers,and were confirmed to have NMIBC by postoperative pathological study. The levels of urine BLCA-4 were measured before and at 1, 3,6 and 12 months after operation. The recurrence of tumor was monitored monthly by cystoscopy. The relationship between preoperative urine BLCA-4 level and clinicopathological parameters was analyzed. Multivariate COX regression analysis was performed to determine the risk factors for postoperative recurrence of NMIBC. Results The level of urine BLCA-4 in 42 patients reached the nadir at 1 month and gradually increased at 3 months after operation. Elevated urine BLCA-4 levels were noted before cystoscopic confirmation in all patients with recurrence of NMIBC. Positivity of urine BLCA-4 was noted up to（8.1＆#177;3.5）months earlier than the confirmation by cystoscopy in these patients. Preoperative urine BLCA-4 level were correlated with tumor grading and clinical staging（both P〈0.05）. Multivariate COX regression analysis showed that preoperative over-expression of urine BLCA-4,and positivity in urine BLCA-4 at 3 and 6 postoperative months were risk factors for NMIBC recurrence（all P〈0.05）.Conclusion Measurement of urine BLCA-4 level is helpful for postoperative surveillance and prognosis evaluation of NMIBC.

关 键 词：膀胱癌特异性核基质蛋白4 酶联免疫吸附测定 肿瘤复发 预后 BLADDER cancer specific NUCLEAR matrix protein 4 

分 类 号：R737.14[医药卫生—肿瘤]