摘要
目的 探讨使用尿组织多肽特异性抗原 (TPS)早期诊断膀胱移行细胞癌 (BTCC)和评估预后的可行性及影响因素。 方法 采用酶联免疫 (ELISA)方法检测尿TPS水平 ,包括 76例新确诊BTCC患者、4 2例BTCC复发患者、2 6例BTCC术后随访尿细胞学检查正常患者、2 8例膀胱良性病变患者、4 2例正常对照 ,并与膀胱镜及手术病理资料结果比较 ,分析尿TPS与膀胱肿瘤发展和预后的关系。 结果 尿TPS水平与年龄和性别无关。新确诊组、复发组、术后随访组、良性病变组TPS分别为 (341± 4 0 3)U/L、(2 12± 16 6 )U/L、(16 8± 115 )U/L、(135± 4 8)U/L ,正常对照组为 (81± 37)U/L ,两两比较差异均有显著性意义 (P均 <0 .0 5 )。以膀胱良性病变 95 %可信值上限值 15 3U/L作为阳性界值 ,诊断新确诊BTCC灵敏度为 85 .5 % ,复发BTCC灵敏度为 4 7.6 %。肿瘤越大、恶性度越高 ,TPS越高 ;在尿细胞学无异常的随访患者中 ,尿TPS >15 3U/L者 6 6 .7% (6 / 9)在 1年内复发。 结论 尿TPS可作为诊断BTCC的瘤标 ,怀疑者应尽早进行膀胱镜检。尿TPS可作为BTCC检查和监测的常规方法 ,但需要与其他方法联用才能够保证其准确性。
Objective To study the application and influential factors of urine tissue polypeptide specific antigen(TPS) for early detection and clinical outcome in bladder transitional cell cancers (BTCC). Methods Urine TPS in 76 cases of newly diagnosed BTCC,42 cases of recurrent BTCC,26 cases of postoperative BTCC with normal urine cytology,28 cases of benign bladder diseases,42 normal controls were determined by ELISA.The TPS levels were compared with the cystoscopic results and pathological findings.The relationship between urinary TPS level and the development and prognosis of BTCC was analyzed. Results The urine TPS level was not related to age and sex.The TPS levels in newly diagnosed BTCC group,recurrent BTCC group,postoperative BTCC with normal urine cytology group, bladder benign diseases group and control group were (341±403)U/L,(212±166)U/L,(168±115)U/L,(135±48)U/L and (81±37)U/L,respectively.There was significant difference between each other (all P <0.05).Using the upper limit of 95% confidence interval of bladder benign disease group (153 U/L) as cutoff,the sensitivity for newly diagnosed BTCC and recurrent BTCC were 85.5% and 47.6%,respectively.The larger and worse of the tumors,the higher TPS levels. 66.7%(6/9) of the normal urine cytology postoperative BTCC patients with TPS higher than 153 U/L developed recurrence within 1 year. Conclusions Higher urine TPS level should be regarded as a marker of BTCC and the suspected cases should have cystoscopy as soon as possible.Urine TPS can be considered routine urine test for early diagnosis and clinical monitoring of BTCC.But it should be used together with other methods to ensure correct diagnosis.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2004年第5期316-318,共3页
Chinese Journal of Urology
