血清异常糖链糖蛋白联合尿细胞角蛋白-19检测对膀胱癌早期诊断的价值  

Study on the application value of serum tumor abnormal protein combined with urine cytokeratin-19 detection in the early diagnosis of bladder cancer

作　　者：吴万文 吕蔡 刘振湘 徐海霞 张淑芳 WU Wan-wen;LYU Cai;LIU Zhen-xiang;XU Hai-xia;ZHANG Shu-fang(Urology Surgery, Pathology Department, Central Laboratory, Haikou People’s Hospital (Central South University XiangyaSchool of Medicine Affiliated to Haikou Hospital), Haikou 570208, China)

机构地区：[1]海口市人民医院(中南大学湘雅医学院附属海口医院)泌尿外科

出　　处：《天津医药》2019年第10期1085-1088,共4页Tianjin Medical Journal

基　　金：2012年度海南省医学普通科研课题(琼卫2012PT-48)

摘　　要：目的探讨血清异常糖链糖蛋白(TAP)联合尿细胞角蛋白-19(CK-19)检测对膀胱癌早期诊断的应用价值。方法回顾性分析50例经病理明确诊断为膀胱癌患者(膀胱癌组)以及45例泌尿系良性疾病患者(对照组),采用凝集法和酶联免疫吸附反应分别检测2组患者血清TAP及尿液中CK-19的水平,比较2组患者TAP及CK-19的水平差异;用二元Logistic回归分析建立TAP与CK-19联合检测的新诊断指标,并绘制ROC曲线分析TAP、CK-19单独及联合检测膀胱癌的诊断价值,同时计算单独检测及联合检测的诊断效能。结果膀胱癌组TAP及CK-19水平显著高于对照组(均P<0.01);TAP联合CK-19检测的ROC曲线下面积[0.918( 95%CI:0.864~0.973)]高于TAP[ 0.876(95%CI:0.809~0.944)]及 CK-19[ 0.821( 95%CI:0.727~0.915)]单独检测的ROC曲线下面积。两指标联合诊断的约登指数(0.83)同样大于两个单独指标(TAP:0.61;CK-19: 0.64),且两指标联合诊断的敏感度(90.00%)和特异度(93.33%)均大于单个指标(TAP:70.00%/91.11%;CK-19:84.00%/80.00%)。结论血清TAP及尿液CK-19联合检测能提升单指标检测的诊断价值及效能,可作为膀胱癌早期诊断的新指标。Objective To investigate the application value of serum tumor abnormal protein (TAP) combined with urine cytokeratin-19 (CK-19) detection in the early diagnosis of bladder cancer. Methods Fifty patients with bladder cancer confirmed by pathology (bladder cancer group) and 45 patients with benign diseases of urinary system (control group) were retrospectively analyzed. The serum levels of TAP and urine CK-19 levels were detected by agglutination method and enzyme linked immunoabsorbent assay in the two groups, respectively. Binary Logistic regression analysis was used to establish a new diagnostic index for TAP and CK-19 combined detection. The ROC curve was drawn to analyze the diagnostic value of TAP and CK-19 separate or combined detection for bladder cancer. The diagnostic efficacy of TAP and CK-19 alone and combined detection was calculated. Results TAP and CK-19 levels were significantly higher in bladder cancer group than those in control group (P<0 .01). The area under the ROC curve detected by TAP combined with CK-19 [0.918 (95%CI: 0.864-0.973)] was higher than that by TAP alone [0.876 (95%CI: 0.809-0.944)] and CK-19 alone [0.821 (95%CI: 0.727-0.915)]. The Youden index of the joint diagnosis of the two indicators (0.83) was also higher than the two separate indicators (TAP: 0.61;CK-19: 0.64), and the sensitivity (90.00%) and specificity (93.33%) of the combined diagnosis of the two indicators were greater than the single indicator (TAP: 70.00%/91.11%;CK-19: 84.00%/80.00%). Conclusion Combined detection of TAP and CK-19 can improve the diagnostic value and efficacy of single indicator detection and can be used as a new indicator for the early diagnosis of bladder cancer.

关 键 词：膀胱肿瘤 癌症早期检测 ROC曲线 异常糖链糖蛋白 细胞角蛋白-19 

分 类 号：R737.14[医药卫生—肿瘤]