三种检测方法对浸润性膀胱癌患者行膀胱部分切除术后复发的预测价值

Predictive value of serum sICAM-1, TSGF and CEA detection for postoperative recurrence of invasive bladder cancer

目的:探讨血清可溶性细胞间黏附分子-1(sICAM-1)、肿瘤特异性生长因子(TSGF)及癌胚抗原(CEA)检测对浸润性膀胱癌患者行膀胱部分切除术后复发的预测价值。方法:选取接受膀胱部分切除联合化疗治疗的浸润性膀胱癌患者75例,根据随访2年内是否复发分为复发组和未复发组。对比两组患者的临床特征和治疗后血清sICAM-1、TSGF及CEA水平的差异,探讨sICAM-1、TSGF及CEA对浸润性膀胱癌患者2年内复发的预测价值。结果:随访2年,75例研究对象中复发26例,复发率为34.67%。复发组与未复发组患者在性别、年龄、肿瘤数目以及肿瘤直径方面比较,差异无统计学意义(P>0.05);而两组患者在病理分期和组织分化程度构成方面差异有统计学意义(P<0.05)。复发组患者血清sICAM-1、TSGF及CEA水平显著高于未复发组(P<0.05),且血清sICAM-1、TSGF及CEA水平高是浸润性膀胱癌患者术后复发的独立危险因素(P<0.05),sICAM-1、TSGF及CEA预测浸润性膀胱癌复发的AUC分别为0.822、0.857、0.852,预测灵敏度为69.2%、73.1%、76.9%,特异度为93.9%、91.8%、87.8%。结论:复发的浸润性膀胱癌患者血清sICAM-1、TSGF及CEA表达水平升高且为术后复发的独立危险因素,在预测浸润性膀胱癌患者复发具有较高应用价值。

Objective:To investigate the predictive value of serum soluble intercellular adhesion molecle-1(sICAM-1),tumor specific growth factor(TSGF)and carcinoembryonic antigen(CEA)for postoperative recurrence of invasive bladder cancer.Methods:Seventy-five patients with invasive bladder cancer treated with hemicyclic combined with chemotherapy were divided into recurrence group and non-recurrence group according to whether recurrence occurred within 2 years of follow-up.The clinical characteristics and serum sICAM-1,TSGF and CEA levels of two groups were compared and the predictive value of sICAM-1,TSGF and CEA in the recurrence of invasive bladder cancer patients within 2 years was explored.Results:Among the 75 subjects,26 had recurrence within 2 years after treatment with the recurrence rate being 34.67%.There was no significant difference in gender,age,tumor number and tumor diameter between relapsed group and non-relapsed group(P>0.05).The difference in pathological stage and tissue differentiation between two groups was significant(P<0.05).The levels of sICAM-1,TSGF and CEA in recurrence group were significantly higher than those in non-recurrence group(P<0.05).High serum sicam-1,TSGF and CEA levels were independent risk factors for postoperative recurrence in patients with invasive bladder cancer(P<0.05).The AUC of sICAM-1,TSGF and CEA for the prediction of recurrence of invasive bladder cancer was respectively 0.822,0.857 and 0.852,with the predictive sensitivity of 69.2%,73.1%,76.9%and the specificity of 93.9%,91.8%,87.8%.Conclusion:Serum sICAM-1,TSGF and CEA expression levels are higher in patients with recurrent invasive bladder cancer.They have high application value in predicting postoperative recurrence of invasive bladder cancer.