联合检测尿液中UBE2C、NMP22在膀胱癌诊断中的临床应用  

Clinical significance of combined test of UBE2C and NMP22 in urine in the detection of bladder cancer

作　　者：周邦奋 梁培育[1] 欧善际[1] 陈振华 陈炜[2] Zhou Bangfen;Liang Peiyu;Ou Shanji;Chen Zhenhua;Chen Wei(Department of Urology,the First Affiliated Hospital of Hainan Medical University,Haikou 570102,China;Department of Urology the First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510080,China)

机构地区：[1]海南医学院第一附属医院泌尿外科,海口570102 [2]中山大学附属第一医院泌尿外科,广州510080

出　　处：《国际泌尿系统杂志》2021年第4期614-617,共4页International Journal of Urology and Nephrology

摘　　要：目的探讨联合检测尿液中人类泛素偶联酶E2C(UBE2C)、核基质蛋白22(NMP22)在膀胱癌诊断中的临床价值。方法选取2013年11月至2014年5月在中山大学第一附属医院收治的膀胱癌患者78例(训练组),同期选取5例肾结石、4例良性膀胱肿物、6例良性前列腺增生、6例血尿症、4例尿路感染患者和16例健康志愿者组成对照A组(41例)。选取2013年11月至2014年7月在中山大学肿瘤研究中心收治的膀胱癌患者111例(独立验证组),同期选取7例肾结石、6例良性膀胱肿物、9例良性前列腺增生、6例血尿症、8例尿路感染患者和24例健康志愿者组成对照B组(60例)。检测并比较UBE2C、NMP>22及两者联合(模型)的诊断准确度,并通过独立验证组对UBE2C、NMP22及模型的诊断准确度进行验证。结果训练组的UBE2C和NMP22浓度均高于对照A组,差异有统计学意义(P<0.0001)。两组UBE2C和NMP22浓度均不受性别、年龄及吸烟情况的影响,差异无统计学意义(P>0.05),但肌层浸润肿瘤和高级别肿瘤的浓度均分别较非肌层浸润肿瘤及低级别肿瘤增高,差异有统计学意义(P<0.05)。独立验证组的UBE2C和NMP22浓度均分别高于对照B组,差异有统计学意义(P<0.0001)。训练组中,UBE2C的曲线下面积(AUC)值为0.779,灵敏度为71%,特异度为85%;NMP22的AUC值为0.793,灵敏度为78%,特异度为80%;模型的AUC值为0.875,灵敏度为87%,特异度为88%;联合检测的模型准确性均优于单一检测,差异有统计学意义(P<0.05)。独立验证组中,UBE2C的AUC值为0.757,灵敏度为78%,特异度为80%;NMP22的AUC值为0.781,灵敏度为77%,特异度为79%;模型的AUC值为0.872,灵敏度为89%,特异度为85%。联合检测的模型诊断性能均优于单一检测,差异有统计学意义(P<0.05)。结论UBE2C可作为膀胱癌诊断的肿瘤标志物,联合UBE2C、NMP22检测可提高膀胱癌诊断的准确度。Objective To investigate the clinical value of detection of ubiquitin-conjugating enzyme E2C(UBE2C)in urine and its combination with NMP22 as noninvasive diagnostic tests for bladder cancer(BCa).Methods From November 2013 to May 2014 in the first affiliated hospital of sun yat-sen university,78 cases of bladder cancer patients(training group)were selected,at the same time 5 cases of kidney stones,4 cases of benign bladder neoplasm,6 cases of benign prostatic hyperplasia,6 cases of hematuria,4 cases of patients with urinary tract infection and 16 cases of healthy volunteers in control group A(41 cases)were selected.From November 2013 to July 2014 in cancer center of sun yat-sen university treated 111 cases of patients with bladder cancer(independent validation group)were selected,in the same period 7 cases of kidney stones,6 cases of benign bladder neoplasm,9 cases of benign prostatic hyperplasia,6 cases of hematuria,8 cases of urinary tract infection and 24 cases of healthy volunteers in control group B(60 cases)were selected.The diagnostic accuracy of UBE2C,NMP22 and the combined model were tested and compared.The diagnostic accuracy of UBE2C,NMP22 and the model was verified by an independent verification group.Results The concentrations of UBE2C and NMP22 in the training group were higher than those in the control group A,and the differences were statistically significant(P<0.0001).The concentrations of UBE2C and NMP22 in the two groups were not affected by gender,age and smoking status,and the differences were not statistically significant(P>0.05),but the concentrations of muscularinvasion and high-grade tumors were higher than those of non-muscularinvasion and low-grade tumors,respectively,and the differences were statistically significant(P<0.05).The concentrations of UBE2C and NMP22 independently verified were higher than those in control group B,respectively,with statistical significance(P<0.0001).In the training group,the AUC value,sensitivity and specificity of UBE2C were 0.779,71%and 85%respectively.The

关 键 词：膀胱肿瘤 尿 UBE2C NMP22 

分 类 号：R737.14[医药卫生—肿瘤]