核基质蛋白22、细胞角质素20和存活素mRNA对膀胱癌诊断价值的研究

摘要

目的 探讨核基质蛋白22(NMP22)、细胞角质素20(CK20)和存活素mRNA在膀胱癌诊断中临床应用价值.方法 选择因血尿和膀胱刺激症状到该院泌尿外科诊治的患者107例,分为对照组(44例)和观察组(63例).观察组中按照肿瘤TNM分期和WHO分级,包括T1s～T1 44例,T2～T4 19例;G1 14例,G2 31例,G3 18例;另外选择45例健康志愿者作为健康组.通过ELISA方法检测所有志愿者尿液中NMP22水平,通过RT-PCR方法检测对照组和观察组受试者尿液中CK20和存活素mRNA表达量,比较这3种检测方法的灵敏度和特异度,以评估对膀胱癌诊断的价值.结果 观察组患者尿液中NMP22的水平(37.92 U/mL)显著高于健康组(4.31 U/mL)和对照组(7.04 U/mL),差异有统计学意义(P＜0.05).NMP22检测指标的灵敏度和特异度分别为82.54％和61.36％,与肿瘤分期和分级无明显相关性;CK20和存活素mRNA检测指标的灵敏度和特异度分别为83.70％、63.64％和85.71％、90.91％,与肿瘤分期有显著的相关性;T2～T4亚组患者CK20和存活素mRNA检测灵敏度高于T1s～T1亚组患者,差异具有统计学意义(P＜0.05).结论 尿液NMP22、CK20和存活素mRNA检测对膀胱癌的诊断均有较高的灵敏度和特异度,是诊断膀胱癌较好的无创性手段.%Objective To investigate the value of nuclear matrix protein 22(NMP22),cytokeratin 20(CK20) and survivin mRNA in the diagnosis of bladder cancer.Methods The research enrolled 107 cases with hematuresis or irritation sign of bladder,who were divided into the control group(44 cases) and the observed group(63 cases).Besides,45 health volunteers were chose as the health group.The urine level of NMP22 was detected by ELISA,and CK20 and survivin mRNA by RT-PCR to evaluate the value in the diagnosis of bladder tumor The sensitivities and specificities of NMP22,CK20 and survivin mRNA were compared and analyzed.Results The urine level of NMP22 in the observed group(37.92 U/mL) was obviously higher than that of health volunteers (4.31 U/mL) and the control group(7.04 U/mL).The difference was significant(P＜0.05).The sensitivity and specificity of NMP22 were 82.54％ and 61.36％ respectively,which was unrelated with the tumor stage.The sensitivities and specificities of CK20 and survivin mRNA were 83.70％,63.64％ and 85.71％,90.91％ respectively,which was positively related with the tumor stage.The sensitivities of CK20 and survivin mRNA in the T2-T4 subgroup were higher than that T1s-T1 subgroup.And there was statistic difference(P＜0.05).Conclusion There are significant evidences that the detections of NMP22,CK20 and survivin mRNA as non-invasive measures could be better methods and higher sensitivity and specificity in diagnosing bladder cancer.