尿液中ErbB3蛋白在肾透明细胞癌早期诊断中的意义

Role of Urine ErbB3 Protein in Early Diagnosis of Clear Cell Renal Cell Carcinoma

【目的】探讨尿液中ErbB3蛋白表达水平对肾透明细胞癌早期诊断的意义。【方法】选取2016年4月26日至2016年8月31日于中山大学附属第一医院泌尿外科住院并接受外科手术治疗,术后病理结果证实为肾透明细胞癌的肾癌患者31例,以及50例经体检证明无泌尿系疾病及其他系统疾病的正常人尿液作为正常对照。使用ELISA法对实验组及对照组尿液中Erb B3蛋白进行检测,比较肾透明细胞癌组和正常对照组之间尿液Erb B3蛋白表达差异,建立使用尿液Erb B3蛋白诊断肾透明细胞癌的ROC曲线,同时分析尿液中Erb B3蛋白含量与患者BMI、肿瘤病理直径、术前肌酐、血压及血糖的相关性。【结果】(1)与正常组相比,肾透明细胞癌组患者尿液Erb B3蛋白浓度明显降低,差异具有统计学意义(P<0.001)。(2)建立使用尿液Erb B3蛋白对肾透明细胞癌进行早期诊断的ROC曲线,曲线下面积为0.802(P<0.001),当取诊断分界值为13.98时,约登指数最大为0.525,对应的诊断试验灵敏度为0.645,特异度0.880。诊断试验的Kappa值为0.542(P<0.001)。(3)实验组患者尿液Erb B3蛋白含量与患者BMI、肿瘤病理直径、术前肌酐、血压及血糖无明显相关性。【结论】肾透明细胞癌患者尿液中Erb B3蛋白含量较正常人明显降低,使用尿液Erb B3蛋白对肾透明细胞癌进行早期诊断具有一定的可行性。

【Objective】To explore the diagnostic value of urine ErbB3protein in clear cell renal cell carcinoma.【Methods】We collected31urine samples of clear cell renal cell carcinoma patients who received operations in the Urology Department of the First Affiliated Hospital of Sun Yat-Sen University from April2,2016to August31,2016.Meanwhile we collected50urine samples of normal people as control.We tested the expression of urine ErbB3protein in experimental group and control group,and analyzed the differences between the two groups.Then we established the ROC curve of which diagnosing clear cell renal carcinoma by urine ErbB3protein.Also,we analyzed the relation between ErbB3protein in urine and the patients’BMI,preoperative creatinine,tumor diameter and underlying diseases such as hypertension and hyperglycemia.【Results】①The expression of urine ErbB3protein in clear cell renal cell carcinoma group was significantly lower than normal group(P<0.001).②When diagnosing clear cell renal carcinoma by ErbB3protein,the AUC of ROC was0.802(P<0.001).When setting the cutoff as13.98pg/mL,the max Youden index was0.525,the sensitivity was0.645and the specificity was0.880.The Kappa value of diagnostic test was0.542(P<0.001).③There was no correlation between the ErbB3content and patients’BMI,tumor diameter or preoperative creatinine by correlation analysis.Also,there was no correlation between the urine ErbB3protein content and blood pressure or blood glucose.【Conclusion】The urine ErbB3protein of clear cell renal cell carcinoma was significantly lower than normal people,and it is meaningful for applying urine ErbB3protein to early diagnosis of clear cell renal cell carcinoma.