膀胱移行细胞癌患者尿脱落细胞中MUC7的表达及其临床意义的研究

MUC7 Expression in Cast-off Cells in Urine of Patients with Bladder Cancer

目的:探讨膀胱移行细胞癌(BTCC)患者尿脱落细胞中MUC7的表达及其临床意义。方法:采用逆转录聚合酶链反应(RT-PCR)检测42例BTCC患者、40例对照者尿脱落细胞中MUC7的mRNA表达,β-actin作为内参照。结果:40例对照组中有2例MUC7 mRNA表达阳性,阳性率为5．0％;42例BTCC患者中36例尿脱落细胞中MUC7 mRNA表达阳性,阳性率为85．7％,其诊断特异性为95％。不同临床分期尿脱落细胞中MUC7 mRNA 的阳性表达率:Ta-T1期为64．3％(9／14),T2-4期为96．4％(27／28)。浸润性BTCC MUC7的阳性表达率显著高于浅表性BTEC(P<0．05)。不同病理分级BTCC患者尿脱落细胞中MUC7的mRNA的阳性表达率为C1 58．3％(7／ 12),C2 93．8％(15／16),G3 100％(14／14)。MUC7 mRNA的表达与BTCC的病理分级呈正相关。MUC7诊断BTCC 的阳性预测值为94．7％,阴性预测值为86．3％。结论:BTCC患者尿脱落细胞中MUC7的阳性表达率明显高于对照组。尿脱落细胞中MUC7表达与临床分期、病理分级呈正相关。采用RT-PCR法检测尿脱落细胞中MUC7表达诊断BTCC的敏感性和特异性好、阳性预测值高,特别对T2-4期肿瘤的诊断敏感性好。

Objective： To study the significance of Muc7 expression in cast-off ceils in the urine of patients with bladder transitimal cell carcinoma（BTCC）. Methods： 42 patients with BTCC were collected in study group and 40 patients without BTCC （20 with urinary cancers other than bladder cancer, 10 with nonneoplastic uninary diseases, 10 healthy volunteers） in contrd group. RT-PCR method was used to detect Muc7 mRNA expression and β-actin as internal positive control in all cases. Results： Only 2 of 40（5% ） cases showed positive expression of Muc7 mRNA in control group. 36 of 42（85. 7% ） cases showed positivity in study group. The sensitivity and specificity of Muc7 examination for diagnosis of BTCC were 85.7% and 95% respectively. According to different clinical staging（Ta-T1 ,T2-4 ）, the positive expression rats of Muc7 mRNA were 64. 3% （9/14） and 96.4% （27/28） respectively. The expression of Muc7 had a positive correlation with the cIinical staging of BTCC. As for the pathological grade of BTCC, the positive expression rates of Muc7 mRNA were 58. 3% in G1, 93.8% in G2, 100% in G3 respectively. The mRNA expression of Muc7 was positively correlated with the pathologic grade of BTCC. The positive and negative predictive values for diagnosis of BTCC were 94. 7% and 86. 3% respectively. Conclusions： I. The positive expression rate of Muc7 in cast-off cells in urine of patients with BTCC is 85.7%, which is significantly higher than that in control group（ P 〈 0.05 ） ; 2. Expression of Muc7 is positviely correlated with the staging and grading of BTCC ; 3. Detecting Muc7 expression with RT-PCR method for diagnosis of BTCC is a method with high sensitivity, specificity and positive predictive value.