尿肿瘤标志物联合检测在膀胱癌早期诊断中的应用价值

Application Value of Combined Detection of Urinary Tumor Markers in the Early Diagnosis of Bladder Cancer

目的:探讨尿肿瘤标志物联合检测在膀胱癌早期诊断中的应用价值。方法:选取笔者所在医院及中山大学附属第一医院2020年1-9月收治的60例膀胱癌患者作为研究组,同期收治的60例泌尿系统急性感染患者作为对照组。对两组NMP22、CD44、CK20、CEACAM1和BTA表达水平进行检测,并且分析研究组5种肿瘤标记物的敏感度、特异度、阳性预测值及阴性预测值,比较不同组合标志物联合检测的敏感度及特异度。结果:对照组NMP22、CD44、CK20、CEACAM1及BTA表达水平和研究组比较,均显著更低(P<0.05)。NMP22、CD44、CK20、CEACAM1及BTA曲线下面积分别为0.749、0.861、0.781、0.733、0.817,其中CD44检测价值最大,当其临界值为350.750 pg/ml时,敏感性和特异性分别可达83.2%和84.4%。综合比较不同组合标志物联合检测,CD44、CK20及BTA这3种肿瘤标记物联合检测的诊断效能比其他组合高,其敏感性及特异性分别为95.7%和81.2%。结论:在膀胱癌患者的早期临床诊断中,尿肿瘤标志物联合检测具有良好的检测应用价值,有利于帮助临床尽早明确诊断。

Objective:To explore the application value of combined detection of urinary tumor markers in the early diagnosis of bladder cancer.Method:Sixty patients with bladder cancer admitted to our hospital and the First Affiliated Hospital of Sun Yat-sen University from January to September 2020 were included in the study group,and 60 patients with acute urinary system infection admitted in the same period were included in the control group.Detected the expression levels of NMP22,CD44,CK20,CEACAM1 and BTA in the two groups,and analyzed the sensitivity,specificity,positive predictive value and negative predictive value of the 5 tumor markers in the study group,and compared the combination of different combinations of markers Sensitivity and specificity of detection.Result:The expression levels of NMP22,CD44,CK20,CEACAM1 and BTA in the control group were significantly lower than those in the study group (P<0.05).The areas under the curves of NMP22,CD44,CK20,CEACAM1 and BTA were 0.749,0.861,0.781,0.733,0.817,respectively.Among them,CD44 had the greatest detection value,when its cut-off value was 350.750 pg/ml,the sensitivity and specificity could reach 83.2% and 84.4%.Comprehensive comparison of the combined detection of different combinations of markers,the diagnostic efficacy of the combined detection of CD44,CK20 and BTA was higher than that of other combinations,and its sensitivity and specificity were 95.7% and 81.2%.Conclusion:In the early clinical diagnosis of patients with bladder cancer,the combined detection of urinary tumor markers has a good value in detection and application,which is beneficial to help the clinical diagnosis as soon as possible.