尿液γ-突触核蛋白诊断膀胱癌的应用价值

The application value of urineγ⁃synuclein in the diagnosis of bladder cancer

目的探讨尿液γ-突触核蛋白(SNCG)对膀胱癌诊断的价值。方法收集2017年1月至2020年4月山西医科大学第五临床医学院和山西省肿瘤医院129例膀胱癌患者(恶性病变组)、157例泌尿系统良性病变患者(良性病变组)和177名健康体检者(健康对照组)的尿液标本,采用酶联免疫吸附试验检测尿液中SNCG浓度,绘制受试者工作特征(ROC)曲线,确定SNCG诊断膀胱癌的灵敏度、特异度和准确度。结果恶性病变组尿液SNCG浓度[4.28 ng/m(l 0.53~8.79)ng/ml]高于健康对照组[1.44 ng/ml(0.56~3.51)ng/ml,H=122.9,P<0.01]和良性病变组[1.97 ng/ml(0.51~5.87)ng/ml,H=88.2,P<0.01],良性病变组高于健康对照组(H=17.1,P<0.01)。尿液SNCG鉴别恶性病变组与健康对照组的ROC曲线下面积(AUC)为0.871(95%CI 0.819~0.923,P<0.01),最佳临界值为2.79 ng/ml,诊断灵敏度和特异度分别为0.798和0.977;尿液SNCG鉴别恶性病变组与良性病变组的AUC为0.823(95%CI 0.769~0.877,P<0.01),最佳临界值为3.54 ng/ml,诊断灵敏度和特异度分别为0.713和0.917;恶性病变组与健康对照组+良性病变组相鉴别的AUC为0.848(95%CI 0.797~0.899,P<0.01),最佳临界值为2.87 ng/ml,诊断灵敏度和特异度分别为0.791和0.901。结论膀胱癌患者尿液中SNCG浓度高于泌尿系统良性病变患者和健康人群,尿液SNCG对膀胱癌的诊断具有较好的应用价值。

Objective To explore the application value of urineγ-synuclein(SNCG)in the diagnosis of bladder cancer.Methods A total of urine samples from 129 patients with bladder cancer(malignant lesion group),157 patients with urinary system benign lesions(benign lesion group),and 177 healthy people(the healthy control group)from January 2017 to April 2020 in the Fifth Clinical Medical College of Shanxi Medical University and Shanxi Provincial Cancer Hospital were collected.The concentration of SNCG in the collected urine was detected by using enzyme-linked immunosorbent assay.The receiver operating characteristic(ROC)curve was drawn to determine its sensitivity,specificity and accuracy for the diagnosis of bladder cancer.Results The urine SNCG concentration in malignant lesion group[4.28 ng/ml(0.53-8.79 ng/ml)]was higher than that in healthy controls[1.44 ng/ml(0.56-3.51)ng/ml,H=122.9,P<0.01]and benign lesion group[1.97 ng/ml(0.51-5.87)ng/ml,H=88.2,P<0.01],and the concentration of urine SNCG in benign lesion group was higher than that in healthy controls(H=17.1,P<0.01).ROC area under the curve(AUC)of urine SNCG in differentiating benign lesion group from healthy controls was 0.871(95%CI 0.819-0.923,P<0.01),the best cut-off value was 2.79 ng/ml,the diagnostic sensitivity and specificity was 0.798 and 0.977,respectively.AUC of urine SNCG in differentiating malignant lesion group from benign lesion group was 0.823(95%CI 0.769-0.877,P<0.01),the best cut-off value was 3.54 ng/ml,the diagnostic sensitivity and specificity was 0.713 and 0.917,respectively.AUC of urine SNCG in differentiating malignant lesion group from healthy controls plus benign lesion group was 0.848(95%CI 0.797-0.899,P<0.01),the best cut-off value was 2.87 ng/ml,the diagnostic sensitivity and specificity was 0.791 and 0.901,respectively.Conclusions The concentration of SNCG in urine of patients with bladder cancer is higher than that of patients with benign urinary lesions and healthy people.Urine SNCG has a good application value in the diagnosis of bladder cancer.