人补体因子H相关蛋白在膀胱癌的诊断、病理分级及临床分期中的应用价值

Application value of human complement factor H-related protein in the diagnosis,pathological grading and clinical staging of bladder cancer

目的探讨尿液中人补体因子H相关蛋白(hCFHrp)在膀胱癌的诊断、病理分级和临床分期中的应用价值。方法回顾性分析2020年4月至12月西京医院收治的69例膀胱癌患者、30例泌尿系良性病变患者及30例体检健康者,采用微孔板化学发光法检测各组尿液hCFHrp水平。分析其与膀胱癌患者临床病理参数的关系,ROC曲线分析其诊断膀胱癌的临床价值。结果膀胱癌组、良性疾病组及健康人对照组尿液hCFHrp的中位浓度及阳性率逐渐下降,差异有统计学意义(H=73.17,P<0.001;χ^(2)=60.14,P<0.001)。hCFHrp水平及阳性率随着膀胱癌患者的WHO病理组织学分级、TNM分期及肿瘤大小的升高而升高(P<0.01)。尿液hCFHrp诊断膀胱癌的ROC曲线下面积(AUC ROC)为0.922,当cut-off值为89.03 U/mL时,敏感性为76.80%,特异性为95.00%。结论尿液hCFHrp可用于膀胱癌的早期筛查,其表达水平与疾病的严重程度密切相关,具有较高的临床诊断价值。

Objective To investigate the application value of urine human complement factor H-related protein(hCFHrp)in the diagnosis,pathological grading and clinical staging of bladder cancer.Methods The urine hCFHrp levels from 69 patients with bladder cancer,30 patients with urinary benign lesions and 30 healthy persons in our hospital during April 2020 and December 2020 were retrospectively analyzed.The urine hCFHrp levels were detected by the microplate chemiluminescence method.The relationship between urine hCFHrp levels and clinicopathological parameters of bladder cancer was analyzed,and the clinical value of urine hCFHrp levels in the diagnosis of bladder cancer was evaluated.Results The median concentration and positive rate of urine hCFHrp in the patients with bladder cancer,patients with urinary benign lesions and healthy controls decreased gradually,and the difference was statistically significant(H=73.17,P<0.001;χ^(2)=60.14,P<0.001).The urine hCFHrp levels and positive rates in the patients with bladder cancer increased with the increase of WHO pathological grading,TNM staging and tumor size(P<0.01).The area under the ROC curve(AUC ROC),cut-off value,sensitivity and specificity of urine hCFHrp in the diagnosis of bladder cancer were 0.922,89.03 U/mL,76.80%and 95.00%,respectively.Conclusion Urine hCFHrp can be used for the early screening of bladder cancer,and its level is closely related to the severity of the disease,which has high clinical value in the diagnosis of bladder cancer.