尿液中基质金属蛋白酶-2和基质金属蛋白酶-9检测对膀胱癌的诊断价值

Diagnostic value of MMP-2 and MMP-9 in urine for bladder cancer

目的探讨尿液中基质金属蛋白酶(MMP)-2和MMP-9水平与膀胱癌发生和发展的关系及早期诊断的价值。方法测定101例膀胱癌患者,88例良性泌尿系统疾病患者及51名健康人尿液中MMP-2和MMP-9的水平。比较3组尿液中MMP-2和MMP-9水平的差异,并比较膀胱癌患者尿液MMP-2和MMP-9水平与肿瘤病理分级的关系。应用受试者工作特征曲线(ROC)进行评价,判断两者的最优截断点并计算其准确度、阳性预测值和阴性预测值。结果膀胱癌患者组尿液中MMP-2和MMP-9水平显著高于良性泌尿系统疾病患者组和健康对照组(P<0.01),Ⅱ级和Ⅲ级膀胱癌患者尿液中MMP-2和MMP-9水平明显高于Ⅰ级(P<0.01)。尿液MMP-2的ROC曲线下面积为0.854,最优截断点为2.4ng/mg蛋白时,准确度为80.8%,灵敏度为81.2%,特异度81.3%;MMP-9的ROC曲线下面积为0.906,最优截断点为6.2ng/mg蛋白时,准确度为87.5%,灵敏度为85.1%,特异度为89.2%;MMP-2和MMP-9联合诊断的灵敏度达到98.0%,特异度为96.4%,准确度为90.0%。结论尿液MMP-2和MMP-9的检测可以用于对膀胱癌的初步诊断,可将其作为膀胱癌的筛选检查项目。

Objective To assess the diagnostic value of MMP-2 and MMP-9 in urine for bladder cancer,and to study the relationship between MMP-2 and MMP-9 levels and the development of bladder cancer.Methods Urinary MMP-2 and MMP-9 levels were detected using enzyme linked immunosorbent assay（ELISA） in 101 patients with bladder cancer,eighty-eight patients with benign urological lesions and fifty-one healthy volunteers.MMP-2 and MMP-9 levels were compared in three groups,and the relationship in different tumor stage groups was evaluated.The optimal cut-offs of MMP-2 and MMP-9 were identified by using ROC curve.Accuracy,positive predictive value and negative predictive value were calculated at optimal cut-off.Results MMP-2 and MMP-9 levels in bladder cancer group were higher than those in benign urological lesions group and control（P0.01）.MMP-2 and MMP-9 levels in grade Ⅱ and Ⅲ in bladder cancer were higher than those in grade Ⅰ（P0.01）.The AUROC of MMP-2 was 0.854,and the optimal cut-off value was 2.4 ng/mg protein.Accuracy was 80.8%,sensitivity was 81.2%,and specificity was 81.3%.The AUROC of MMP-9 was 0.906,and the optimal cut-off value was 6.2 ng/mg protein.Accuracy was 87.5%,sensitivity was 85.1%,and specificity was 89.2%.Combination of MMP-2 and MMP-9 reached to accuracy 90.0%,sensitivity 98.0% and specificity 96.4%.Conclusion MMP-2 and MMP-9 in urine might have great diagnostic potentials for bladder cancer.