血清和尿 CY FRA21-1水平对膀胱癌的诊断价值

摘要

Objective To investigate the diagnostic value of serum and urine cytokeratin fragment 19 antigen 21‐1 (CYFRA21‐1 ) levels in bladder cancer .Methods The concentrations of serum and urine CYFRA21‐1 in 63 patients with newly diagnosed bladder cancer (group A ) , 80 patients without bladder cancer (group B) and 31 healthy volunteers (group C) .The diagnostic efficiency of serum and urine CYFRA21‐1 was evaluated by drawing receiver‐operating characteristic (ROC ) curves .The correlation between serum CYFRA21‐1 and urine CYFRA21‐1 and their relationship with stage of bladder cancer were analyzed .Results Concentrations of serum and urine CYFRA21‐1 were higher in group A than those in groups of B and C(P<0 .01) .The areas under ROC curve for serum and urine CYFRA21‐1 were similar(0.77 vs .0.73)(P>0 .05) .Taking 3.95 μg/L and 4.00μg/L as the cutoff values of serum and urine CYFRA21‐1 for the diagnosis of bladder cancer ,the sensitivities w ere 65% and 57% ,and the specificities w ere 90% and 82% ,respectively .T he level of CYFRA21‐1 in serum was positively correlated to that in urine in group A ( r=0 .38 , P<0 .01) ,which were increased as tumor stage increased(P<0 .01) .Conclusion Detection of serum and urine CYFRA21‐1 has a certain value in the diagnosis and prognosis evaluation in the patients w ith bladder cancer .%目的：探讨血清和尿细胞角蛋白片段19抗原21‐1（CYFRA21‐1）水平对膀胱癌的诊断价值。方法检测63例初诊膀胱癌患者（A组）、非膀胱癌患者80例（B组）和健康受试者31例（C组）血清和尿CYFRA21‐1浓度。绘制受试者工作特征（ROC）曲线评价血清和尿CYFRA21‐1对膀胱癌的诊断效能，分析A组血清和尿CYFRA21‐1浓度相关性及与膀胱癌分期的关系。结果 A组血清和尿CYFRA21‐1浓度均高于B、C组（P＜0．01）。血清和尿CYFRA21‐1诊断膀胱癌ROC曲线下面积相仿（0.77 vs ．0.73）（P＞0．05）。当血清和尿CYFRA21‐1诊断膀胱癌的最佳界值分别为3.95μg／L和4.00μg／L时，其诊断敏感度分别为65％和57％，特异度分别为90％和82％。A组血清和尿CYFRA21‐1浓度呈正相关（r＝0．38，P＜0．01），且二者均随膀胱癌分期递进而增加（P＜0．01）。结论检测血清和尿CYFRA21‐1对膀胱癌具有一定的诊断和预后评估的价值。