生存素检测在膀胱癌实验诊断中的意义

Significance of survivin in the diagnosis of bladder cancer

目的:检测膀胱癌患者血液和尿液细胞中生存素(survivin)基因的表达并评价其临床意义。方法:取40例膀胱移行细胞癌患者(TCC组)、19例其他泌尿系统疾病患者(对照组)和20名健康成人(正常人组)的外周血和新鲜尿液,以实时逆转录-聚合酶链反应(RT-PCR)检测外周血有核细胞及尿液脱落细胞中生存素基因的表达,并检测甘油醛-3-磷酸脱氢酶(GAPDH)基因的表达作为对照。结果:TCC组患者外周血生存素25例阳性(62.5%),对照组和正常人组均为阴性;尿脱落细胞检测结果示TCC组28例阳性(70.0%),对照组仅2例阳性(10.5%),而正常人组均为阴性。TCC组阳性率与其他2组差异有显著性(P<0.01),而在不同病理分级的TCC患者的阳性率无统计学差异(P>0.05)。合并分析血液和尿液中的生存素检测结果对TCC的总检出率达87.5%,对TCC组Ⅱ级和Ⅲ级的检出率(96.6%)显著高于Ⅰ级(63.6%)(P<0.05)。结论:生存素基因在膀胱癌患者血液和尿液细胞中重新表达,运用实时RT-PCR法测定血液和尿液细胞中生存素表达具有较好的肿瘤特异性,可作为一种新的检测膀胱癌的无创性方法。

Objective To study the survivin gene expression in the peripheral blood and the exfoliated urothelial cells and to evaluate its clinical significance in the diagnosis of bladder cancer. Methods: Real-time RT-PCR was used to detect survivin-mRNA in the blood and the urine of 40 patients with bladder cancer (transitional cell carcinoma, TCC), 20 healthy volunteers and 19 patients with other urinary diseases. Results Twenty five of 40 TCC patients were positive (62.5%) of blood survivin and no positive result was found in all the 20 healthy volunteers and 19 patients with other urinary diseases. For urine specimen, 28 out of 40 TCC patients were positive (70%) and 2 of 19 cases of other diseases were positive (10.5%). No positive result was found in 20 healthy controls. The positive rates of survivin in TCC were significantly higher than that in the controls(P <0.01), while the difference among the patients with various pathological grades did not exist(P >0.05). The combined analysis of survivin detection in the blood and the urine showed that the total positive rate was 87.5% in TCC. The positive rate(96.6%) in TCC patients with gradeⅡand Ⅲ was significantly higher than that in patients with grade Ⅰ. Conclusions Real-time RT-PCR detection of survivin can be used as a new noninvasive method for the diagnosis of bladder cancer.