尿细胞角蛋白检测与尿脱落细胞学检查在膀胱癌诊断中的价值

Comparison between urinary cytokeratin test and voided urine cytology for detection of bladder cancer

目的:探讨尿细胞角蛋白检测与尿脱落细胞学检查在膀胱移行细胞癌诊断中的价值。方法:136例怀疑膀胱癌者,进行尿细胞角蛋白8和18的含量(UBC值)。检测与尿细胞学检查,其中87例经组织学证实为膀胱移行细胞癌。比较两者诊断膀胱癌的敏感性和特异性。结果:尿细胞角蛋白的敏感性为70.1%,特异性为73.3%;尿细胞学的敏感性为42.5%,特异性为83.7%。尿细胞角蛋白在膀胱癌不同分级和分期中的敏感性优于尿细胞学(P<0.05)。结论:尿细胞角蛋白的检测在早期诊断膀胱癌方面优于尿细胞学检查,可作为膀胱癌的早期检测指标。

Purpose： To compare the sensitivity and specificity of urinary cytokeratin test with voided urine cytology in detection of bladder cancer and to evaluate their clinical values. Methods： For 136 patients suspected to have bladder cancer urinary concentrations cvtokeratin 8 and 18 and cytology were eonducted in the same voided urine samples. Of them 87 patients with bladder transitional cell carcinoma were confirmed histologically The sensitivity and specificity of urinary cytokeratin and urine cytology were aualvzed. 49 patieuts without bladder cancer were selected as control. Results： The overall sensitivity aud specificity of urinary cvtokeratin test were 70.1% and 73.3%, respetively , those of urine cytology were 42.5% and 83.7%. respectively, there was no significant difference between the specificity of urine cytology and that of urinary cvtokeratin test ; however, urinary cvtokeratin was significantly more sensitive than urine cytology in detection of any stages and grades of bladder cancer （ P 〈 0. 05）. Conclusions： The urinary eytokeratin test is superior to voided urine cytology in sensitivity and it is a potent adjunctive parameter to cystoscopy for early detection and monitoring of bladder cancer.