尿透明质酸酶、透明质酸及其联合检测对膀胱癌诊断和治疗的意义

目的：探讨尿透明质酸酶（HAase）和透明质酸（HA）联合检测对膀胱癌诊断和治疗的意义。方法：取自40位膀胱癌患者术前（40份）及术后（40份）尿液标本80份，另20份尿液取自对照组（包括正常人、泌尿生殖系其他疾病患者）。采用酶联免疫标记技术检测尿液HAase和HA水平。并对其结果进行讨论分析。结果：患者术前组中HAase水平是术后组的1．5倍（P〈0．05），是对照组的2～4倍（P〈0．05）；而术前组中HA水平是术后组的1．5倍（P〈0．05），是对照组的1．5～3倍（尸〈0．05），HAase、HA联合检测在膀胱癌诊断中具有较高的灵敏度（91％）、特异度（82％）和精确度（89％）。结论：HAase和HA联合检测是诊断膀胱癌和手术评估的一种非侵入性、高灵敏度、高特异度的检测方法。

联合检测尿液NMP22与HA在膀胱癌诊断中的应用

[目的]探讨尿液细胞核基质蛋白22（NMP22）和透明质酸（HA）联合检测在膀胱癌诊断中的意义。[方法]膀胱癌患者（A组）88例，膀胱炎患者（B组）132例、健康对照（C组）80例，收集其晨尿10mL，对尿液中NMP22定性检测，定量检测HA含量，比较HA、NMP22单独检测与两者联合检测对膀胱癌诊断的价值。[结果]A组、B组和C组尿液HA含量分别为（353．42±56．13）ng／mg，（254．12±40．19）ng／mg和（128．3±21．2）ng／mg，A组高于B组和C组（P〈0．05），B组高于C组（P〈0．05）；A，B，C组尿液NMP22阳性率分别为63．6％（56／88），11．4％（15／132）和10．0%（8／80），A组高于B组和C组（P〈0．05），B组与C组阳性率相比较差异无显著性（P〉0．05）。HA单独检测诊断膀胱癌的敏感性为88．6％（78／88），特异性为82．5％（175／212），准确度为84．3％（253／300）；NMP22的敏感性为64．2（56／88），特异性为89．2％（189／212），准确度为81．7％（245／300）；HA与NMP22联合检测诊断膀陇癌的敏感性为95．5％（84／88），特异性为96．7％（205／212），准确度为96．3％（289／300）；HA与NMPP22联合检测的敏感性、特异性和准确性均要高于HA和NMP22任一单独检测。[结论]联合检测尿液NMP22与HA要优于单独检测，可提高对膀胱癌的诊断效能。

The Value of the Measurement of Urinary Hyaluronic Acid Levels for the Diagnosis of Bladder Cancer

Objective To investigate the value of the measurement of urinary hyaluronic acid (HA) levels for the diagnosis of bladder cancer and the possibility of replacing ELISA-like assay with radioimmunoassay to detect the levels of urinary HA. Methods Using the ELISA-like assay and radioimmunoassay at the same time to measure the HA levels in the urine specimens from 49 bladder cancer patients, 12 benign bladder tumor patients, 30 other genitourinary disease patients and 20 normal controls. Results There is not much difference between the consequences of the urinary HA levels whether we used the ELISA-like assay or radioimmunoassay to detect every specimen (P>0.05). When we used the results with radioimmunoassay for analysis, we found the levels of urinary HA of bladder cancer patients were 2–4 times than those of the benign bladder tumor patients, other genitourinary disease patients or normal individuals (P<0.01); With 137.5 ngHA/mg protein (113.6±23.9 ng/mg) as a minimum cutoff limit, this assay had a good sensitivity (91.8%) and specificity (91.9%) for the diagnosis of bladder cancer. Its difference in sensitivity meant a lot when compared with urine cytology (48.9%,P<0.01). Conclusion The urinary HA assay is a simple, convenient, noninvasive credible and cheap method with satisfactory sensitivity and specificity for the diagnosis of bladder carcinoma; radioimmunoassay is also a good means to measure the urinary HA levels. Key words Bladder carcinoma - Hyaluronic acid - Urine