尿中脱落细胞的环氧化酶-2、ImmunoCyt和透明质酸酶联合检测在膀胱癌早期诊断中的应用

Clinical Study on the value of Cox-2,ImmunoCyt and HAase in urine exfoliated cells in early diagnosis of bladder transitional cell carcinoma

目的评价尿中脱落细胞的环氧化酶-2(Cox-2)、ImmunoCyt和透明质酸酶(HAase)测定在膀胱癌早期诊断中的应用价值,寻找早期诊断膀胱癌的有效方法。方法选择60例早期膀胱移行细胞癌和60例非膀胱肿瘤患者,对尿中脱落细胞的Cox-2、ImmunoCyt和透明质酸酶(HAase)进行检测,并行尿脱落细胞学检查。结果尿中脱落细胞的Cox-2、ImmunoCyt、HAase和尿脱落细胞学的敏感度分别为60%、61.6%、66%、26.6%;准确度分别为76%、74%、80%和87%;特异度分别为92%、90%、94%和100%。Cox-2+ImmunoCyt+HAase联合检测与Cox-2、ImmunoCyt和HAase单独检测相比,敏感度和准确度都有所提高(P<0.05);尿中脱落细胞的Cox-2、ImmunoCyt和HAase联合检测的敏感性和准确性均高于尿脱落细胞学,差异有统计学意义(P<0.05)。结论尿中脱落细胞的Cox-2、ImmunoCyt和HAase是早期诊断膀胱移行细胞癌的一种高特异性指标,三者联合检测能提高膀胱癌的早期诊断率。

Objective To evaluate clinical significance of Cox-2,ImmunoCyt and Hyaluronidase（HAase） in urine exfoliated cells in early diagnosis of bladder transitional cell carcinoma,and find a favorable method for bladder transitional cell carcinoma（BTCC）. Methods Cox-2,ImmunoCyt and HAase in urine exfoliated cells were detected from 60 cases with early BTCC and other 60 con- trois,and exfoliative cytology were detected too. Results The resuts showed that the sensitivities of Cox-2,ImmunoCyt, H Aase in urine exfoliated cells and exfoliative cytology was 60 %, 58 %, 66 %, 76 %, the accuracy was740%, 80 %, 87 % and 22.0 % respective ly, the specificity was 92 %, 90 %, 94 % and 100 % respectively. The diagnosis sensitivity and accuracy of tumor marker combined detection were significantly higher than that alone （P〈0.05）. but the sensitivity and accuracy of Cox-2,ImmunoCyt and HAase in urine exfoliated cells were significantly higher than those of urinary cytology （P〈0.05）. Conclusion Cox-2, ImmunoCyt and HAase in urine exfoliated cells are specific markers in the early diagnosis of BTCC. The combined detection can improve the early diagnosis rate of carcinoma of urinary bladder.