膀胱肿瘤抗原、尿核基质蛋白22、细胞角蛋白-19对膀胱癌的诊断价值分析

Diagnostic value of bladder tumor antigen,urinary nuclear matrix protein 22 and cytokeratin-19 in bladder cancer

目的分析膀胱肿瘤抗原(BTA)、尿核基质蛋白22(NMP22)、细胞角蛋白-19(CK-19)对膀胱癌的诊断价值。方法选取53例膀胱癌患者作为膀胱癌组,49例泌尿系良性疾病患者作为对照组。比较两组患者CK-19、NMP22及BTA水平,分析三者水平与膀胱癌患者临床特征的关系,分析CK-19、NMP22及BTA单独及联合检测对膀胱癌的诊断价值。结果膀胱癌组患者尿液NMP22、BTA及血清CK-19水平均明显高于对照组,差异均有统计学意义(P﹤0.01)。肿瘤分期为Ⅲ~Ⅳ期的膀胱癌患者尿液NMP22、BTA及血清CK-19水平均明显高于Ⅰ~Ⅱ期患者,差异均有统计学意义(P﹤0.01)。CK-19、NMP22及BTA联合检测诊断膀胱癌的灵敏度和特异度分别为0.805和0.869,曲线下面积(AUC)为0.854(95%CI:0.774~0.934),均高于CK-19、NMP22及BTA单独检测。结论膀胱癌患者CK-19、NMP22及BTA水平显著升高,三者水平升高与肿瘤分期相关,密切监测三者水平变化可为临床诊断膀胱癌提供依据。

Objective To evaluate the diagnostic value of bladder tumor antigen(BTA),urinary nuclear matrix pro-tein 22(NMP22)and cytokeratin-19(CK-19)in bladder cancer.Method A total of 53 patients with bladder cancer were selected as bladder cancer group and 49 patients with benign diseases of urinary system were selected as control group.The levels of CK-19,NMP22 and BTA were compared between the two groups,and the relationship between the levels of CK-19,NMP22,BTA and clinical characteristics of patients with bladder cancer were analyzed.The diagnostic value of CK-19,NMP22 and BTA alone and combined detection in bladder cancer were analyzed.Result Urine NMP22,BTA and serum CK-19 levels in bladder cancer group were significantly higher than those in control group,the differences were statistically significant(P<0.01).Urine NMP22,BTA and serum CK-19 levels in bladder cancer patients with tumor stage III to IV were significantly higher than those in patients with stage I to II,and the differences were statistically sig-nificant(P<0.01).The sensitivity and specificity of CK-19,NMP22 and BTA combined detection in the diagnosis of blad-der cancer were 0.805 and 0.869,respectively,and the area under the curve(AUC)was 0.854(95%CI:0.774-0.934),which were higher than those of CK-19,NMP22 and BTA alone detection.Conclusion The levels of CK-19,NMP22 and BTA are significantly increased in patients with bladder cancer,and related to the tumor stage.Close monitoring of the changes of the levels of the three indexes can provide evidence for the clinical diagnosis of bladder cancer.