尿脱落细胞Cox-2 mRNA检测在膀胱癌诊断中的价值

Detection of Cox-2 mRNA in exfoliated cells in urine for the diagnosis of bladder cancer

目的 :探讨尿脱落细胞Cox 2基因检测在膀胱癌诊断中的价值。方法 :采用逆转录聚合酶链反应(RT PCR)半定量法检测 31例膀胱癌患者、4 2例泌尿系良性疾病患者和 8例健康志愿者清晨中、后段尿脱落细胞Cox 2mRNA的表达 ,并与尿脱落细胞学检查相对照。结果 :用RT PCR法检测尿脱落细胞Cox 2mRNA用于诊断膀胱癌的特异性为 72 .1% ,低于尿脱落细胞学检测 (10 0 % ) (P <0 .0 5 ) ,但敏感性为 10 0 % ,高于尿脱落细胞学检测 (6 4 .5 % ) (P <0 .0 1)。;表达Cox 2mRNA的部分膀胱良性疾病患者 ,其强度与G1膀胱癌患者之间的差异无统计学意义 (P >0 .0 5 ) ,但与G2 、G3 膀胱癌患者之间的差异有统计学意义 (P <0 .0 5 ) ;膀胱癌患者尿脱落细胞Cox 2mRNA的表达强度随膀胱癌分级的增高而升高 (P <0 .0 5 ) ;浸润性膀胱癌患者表达Cox 2的强度高于浅表性膀胱癌患者 (P <0 .0 1)。结论 :采用RT PCR法检测尿脱落细胞Cox 2mRNA的表达可作为膀胱癌早期诊断、复发监测的一项极其灵敏的方法 ,并有助于肿瘤分级分期的判断。

Objective:To discuss the significance of detection of Cox-2mRNA in exfoliated cells in urine for the diagnosis of bladder cancer.Methods:The middle and later urine voided firstly in the morning were collected from 31 patients with bladder cancer 、42 with bladder benign lesions and 10 normal individuals. RT-PCR was performed for the Cox-2 mRNA in urine exfoliated cells. The cytology analysis was carried out simultaneously.Results:Cox-2 RT-PCR from urine exfoliated cells has lower specificity ( 64.5 %) than that of cytology analysis(P<0.01), but its sensitivity is 100% Which is significantly higher than that of cytological examination( 72.1 %)(P< 0.01 ). A part of exfoliated cells in urine from bladder benign lesions may have the expression of Cox-2 mRNA with the same expression intensity as grade I bladder cancer (P> 0.05 ) and significantly lesser intensity than that of grade II、III bladder cancer(P<0.05). As to bladder cancer, greater expression intensity of Cox-2 in differentially high grade compared with in low grade greater intensity of Cox-2 in high pathological stage (T 2～T 4) compared with in low stage (T a～T 1).Conclusions:Cox-2mRNA RT-PCR is an extremely sensitive method for the early diagnosis,postoperative inspection of bladder cancer and helps to confirm the grade and stage of bladder cancer too.