ImmunoCyt和尿脱落细胞学检查对膀胱移行细胞癌的早期诊断价值

ImmunoCyt for the Early Diagnosis of Bladder Transitional Cell Cancer （a Report of 138 Cases）

【目的】探讨ImmunoCyt检查在膀胱移行细胞癌早期诊断和随访中的作用。【方法】2006年9月至2008年3月对可疑膀胱癌患者138例，其中25例经尿道膀胱肿瘤电切术后的随访者，113例有肉眼或镜下血尿患者，分别进行尿脱落细胞学和ImmunoCyt检查。所有病人均行膀胱镜检查，对可疑组织活检。【结果】膀胱镜检和病理证实34例为膀胱移行细胞癌。ImmunoCyt敏感性为88．2％，与尿脱落细胞学检查（47．1％）相比差异有显著性意义（PdO．05）。两种检查方法相结合的敏感性为91．2％。ImmunoCyt和尿脱落细胞学的特异性分别为80．4％和95．3％。【结论】早期检出膀胱癌ImmunoCyt较尿细胞学更敏感，二者结合使用可在保持高特异性的同时提高敏感性，适合大规模可疑人群的普查及复发可能性较小的低级、低期膀胱癌的术后随访。

[Objective] To study the role of ImmunoCyt test in the early diagnosis and follow-up of bladder transitional cell cancer. [Methods] A total of 138 suspected patients with bladder cancer were included. Among them 25 cases had undergone transurethral resection of superficial transitional cell carcinoma and had been followed up for at least 3 months. The other 113 cases had hematuria. All the patients were evaluated with both standard cytology and ImmunoCyt test. Then all of them underwent cystoscopy and suspected lesions underwent biopsy. [Results] Twenty eight cases were confirmed to be transitional cell cancer. The sen- sitivity of ImmunoCyt was 88.2 %, while that of cytology was 47.1%. When they were combined, the sensitivity was 91.2%. The specificity of ImmunoCyt was 80.4%, while that of cytology was 95.3%. [Conclusion] The sensitivity of ImmunoCyt is higher than that of cytology. When they are combined, the sensitivity and specificity can be improved. They are suitable for mass survey and follow-up after operation in the early diagnosis of bladder cancer with low grade and stage and less possibility.