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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(0.77vs.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。
Objective To investigate the diagnostic value of serum and cytokeratin 19 antigen 21-1 (CYFRA21-1) in bladder cancer. Methods Serum and urinary CYFRA21-1 concentrations were measured in 63 newly diagnosed bladder cancer patients (group A), 80 patients without bladder cancer (group B) and 31 healthy subjects (group C). The receiver operating characteristic (ROC) curve was drawn to evaluate the diagnostic efficacy of serum and urinary CYFRA21-1 in bladder cancer. The correlation between serum and urinary CYFRA21-1 concentration in group A and the relationship with the staging of bladder cancer was analyzed. Results The serum and urinary CYFRA21-1 concentrations in group A were higher than those in groups B and C (P <0.01). The area under the ROC curve of serum and urinary CYFRA21-1 in diagnosis of bladder cancer was similar (0.77 vs. 0.73) (P> 0.05). The diagnostic sensitivity of CYFRA21-1 was 65% and 57% respectively when the best cutoff value of CYFRA21-1 was 3.95μg / L and 4.00μg / L respectively, and the specificity was 90% and 82% respectively. Serum and urinary CYFRA21-1 concentrations in group A were positively correlated (r = 0.38, P <0.01), both of which increased with the progression of bladder cancer (P <0.01). Conclusion The detection of serum and urinary CYFRA21-1 in bladder cancer has some diagnostic and prognostic value.