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目的评价尿核基质蛋白22(NMP22)在膀胱尿路上皮癌术后监测中的临床意义,并与尿细胞学检查相比较。方法留取117例有膀胱尿路上皮癌病史患者的晨尿,应用免疫酶标记法(ELISA法)检测尿中NMP22的数值,同时行尿细胞学检查。所有患者均行膀胱镜检查,并对肿瘤或可疑病变处取膀胱组织送病检,以病理学为最后诊断标准。分析NMP22、尿细胞学检查结果与复发膀胱尿路上皮癌分期、分级的相关性。结果膀胱镜证实39例患者复发。NMP22以6.4U/ml为临界值,阳性33例,NMP22的敏感性为84.6%;尿细胞学检查阳性16例,敏感性为41.2%,两者之间有显著性差异(P﹤0.05)。NMP22对于低级别膀胱尿路上皮癌敏感性是细胞学的8倍。NMP22与细胞学特异性分别为74.2%和92.1%。两者联合检测敏感性增加至91%。结论所有分期、分级的复发膀胱尿路上皮癌NMP22的敏感性均高于尿细胞学检查,两者联合可以提高诊断的敏感性,但在随访过程中尚不能完全取代膀胱镜检查。
Objective To evaluate the clinical significance of NMP22 in postoperative surveillance of bladder urothelial carcinoma and to compare it with urinary cytology. Methods One hundred and thirteen patients with bladder urothelial carcinoma were enrolled in the morning urine. Enzyme - linked immunosorbent assay (ELISA) was used to detect the value of NMP22 in the urine. Urinary cytology was performed simultaneously. All patients underwent cystoscopy, and the tumor or suspicious lesions taken from the bladder tissue disease examination, the pathology as the final diagnostic criteria. Analysis of NMP22, urinary cytology findings and recurrent bladder urothelial carcinoma staging, grade correlation. Cystoscopy confirmed the recurrence of 39 patients. In NMP22, the positive rate of NMP22 was 6.4 U / ml, 33 cases were positive, the sensitivity of NMP22 was 84.6%, and 16 cases of urine cytology were positive. The sensitivity was 41.2%. There was a significant difference between the two (P <0.05). NMP22 is 8 times more cytotoxic for low-grade bladder urothelial carcinoma. The cytotoxic specificity of NMP22 was 74.2% and 92.1%, respectively. The combined detection sensitivity increased to 91%. Conclusion The sensitivity of all staging and grading recurrent bladder urothelial carcinoma (NMP22) is higher than that of urinary cytology. The combination of the two can improve the diagnostic sensitivity, but it can not completely replace the cystoscopy in the follow-up.