尿CYFRA21-1、端粒酶、VEGF联合检测膀胱移行细胞癌的价值

Combination of Urinary CYFRA21-1,Urinary Telomerase and VEGF to Detect Bladder Transitional Cell Carcinoma

目的 探讨反映肿瘤发生发展不同阶段的尿瘤标联合 ,检测膀胱移行细胞癌 (BTCC)的价值。方法 4 5例BTCC患者 ,同时分别以抗体夹心ELISA方法检测尿CYFRA2 1 1、VEGF、TRAP方法检测尿端粒酶。联合检测的灵敏度与单一瘤标及尿细胞学检测结果比较 ,χ2 检验。结果 尿CYFRA2 1 1、端粒酶、VEGF诊断BTCC的灵敏度分别为 82 .2 %、77.8%、84 .4 % ,与尿细胞学 (44 .4 % )比较 ,均有显著性差异 (P <0 .0 0 5 ) ;联合瘤标诊断BTCC的灵敏度为 95 .6 % ,与尿细胞学 (P <0 .0 0 5 )、尿端粒酶(0 .0 2 5 <P <0 .0 5 )结果比较 ,分别有显著性差异 ;但与尿CYFRA2 1 1(0 .0 5 <P <0 .10 )、尿VEGF(0 .10<P <0 .2 5 )结果分别比较 ,尚无显著性差异。结论 把针对肿瘤生物学行为不同阶段的尿瘤标联合 ,能有效提高诊断的灵敏度 ,防止漏诊 ,是一种更有希望的BTCC检测手段。

Objective To explore the value of combined determination of urinary tumor markers for bladder transitional cell carcinoma(BTCC), which reflects the different stages of tumor genesis and progress. Methods Voided urine samples of 45 patients with BTCC were collected and divided into different aliquots for each tumor marker analysis. CYFRA21-1 and VEGF were measured by ELISA, telomerase was determined by TRAP. The sensitivity of combined determination was compared with that of individual tumor marker and urinary cytology respectively, Chi-square test was used for hypothesis testing. Results Sensitivities for diagnosing BTCC in this study were 82.2% for urinary CYFRA21-1, 77.8% for telomerase, 84.4% for VEGF. Compared to that of cytology( 44.4%), there was significant difference respectively (P< 0.005). The sensitivity of combined determination was 95.6%, there was significant difference compared to that of urinary telomerase ( 0.025<P< 0.05) or cytology (P< 0.005); but there was no difference compared to that of CYFRA21-1 ( 0.05<P< 0.10) or VEGF ( 0.10<P< 0.25). Conclusion The combined determination of urinary CYFRA21-1,telomerase and VEGF which reflect the different stages of tumor genesis and progress was more effective; it maybe have higher value to detect BTCC.