人膀胱癌细胞角蛋白20 mRNA表达的研究

Study on expression of cytokeratin 20 mRNA in urine exfoliated cells from patients with bladder carcinoma

目的 评估细胞角蛋白 2 0mRNA(CK2 0mRNA)是否可以作为膀胱癌临床诊断的一种有用标志物。方法 对 84例肉眼血尿患者的尿液进行尿脱落细胞学及CK2 0mRNA标记物RT/PCR检测。分析参数包括肿瘤数目、大小及WHO分级 ,术前或活检前尿脱落细胞学和CK2 0mRNA标志物。结果 病理活检证实 2 2例移行细胞癌中 ,CK2 0mRNA 18例为阳性 ,4例阴性 ;6 2例非膀胱癌患者中 ,CK2 0mRNA标志物 2例假阳性。与尿脱落细胞学比较 ,CK2 0mRNA标志物对膀胱移行细胞癌诊断的特异性和阳性预报值更高 ,分别为 96 .8%比 77.4 % (U =3.2 1,P <0 .0 1) ,90 %比 5 1.7% (U =2 .81,P <0 .0 1) ;但两者在敏感性和阴性预报值间无显著性差异 (U值分别为 :1.0 4和 1.2 1,P >0 .0 5 )。CK2 0mRNA表达与肿瘤分级间无明显相关性。结论 通过RT/PCR方法检测CK2 0mRNA是诊断膀胱移行细胞癌的一种良好生物标志物 ,其特异性明显优于尿脱落细胞学。

Objective To study whether cytokeratin 20(CK20) mRNA expression could be used as a bladder tumor marker for transitional cell carcinoma. Methods RT/PCR for testing CK20 mRNA was done with exfoliated cells isolated from 84 hematuria patients urine samples. The parameters were tumor grade, tumor size, number of tumors, urinary cytology and CK20 mRNA expression. Results In the urine samples of 22 bladder cancer patients, 18 expressed CK20 mRNA marker. Four false negative results were found. Among 62 patients without bladder cancer, two false positive results were found. Comparing CK20 mRNA marker tested by RT/PCR with urinary cytology, the specificity and positive predictive value of former were much higher (96.8% versus 77.4%, 90% versus 51.7% respectively, U value 3.21 and 2.81, P <0.01). There was no correlation between CK20 mRNA and tumor grade. Conclusion Our results indicate that CK20 mRNA by RT/PCR assay is a potential biomarker for noninvasive detection of bladder carcinoma. The CK20 mRNA marker was significantly more sensitive than urinary cytology.