尿膀胱肿瘤抗原在膀胱癌表达的意义及检测的影响因素

发布时间：2018-04-16 02:36

  本文选题：ELISA + BTA　； 参考：《广西医科大学》2017年硕士论文

【摘要】：目的探讨尿膀胱肿瘤抗原(BTA)的临床应用价值及血尿对检测的影响。方法1.第一部分研究为三组,将46例膀胱癌、35例泌尿系良性疾病、10例健康者尿液纳入研究,分别设为膀胱癌组、良性疾病组、健康对照组。各组样本同时作尿脱落细胞学及BTA检测。2.第二部分实验为两组,分别为血尿模型组和膀胱癌组。设计血尿模型:将10个健康体检者纳入研究,留取各实验对象的尿液50ml及自体血液2ml,取各健康者0、1、5、50、100 ul血液样品分别与10 ml自体尿液混匀,分别制成0,1/10000,1/2000,1/200,1/100各5种不同比例的血尿;膀胱癌组为50个膀胱癌患者新鲜晨尿;以光学显微镜观察两组样本高倍镜下血尿浓度,并应用ELISA法测定各样本中BTA含量。结果1.BTA检测的AUC为0.863,95%可信区间为(0.759、0.924),尿细胞学的AUC为0.670,95%可信区间为(0.550、0.775),两组AUC差别有统计学意义(P=0.000);2.膀胱癌组BTA水平与良性疾病组、健康组差别有统计学意义(P0.01);3.BTA表达水平和敏感性与肿瘤分级分期、有无肉眼血尿有关(P0.01),复发膀胱癌BTA表达水平与初发组差别无统计学意义(Z=-0.721,P=0.324);BTA对各级、各期的膀胱癌的灵敏度均高于尿细胞学(P0.01);3.BTA在早期膀胱癌(Ta-T1期)中表达水平与良性疾病组、健康组差别有统计学意义(P0.01);4.血尿模型组:血尿浓度与BTA含量成正相关(rs=0.98 P=0.00),BTA值随血尿浓度升高而升高。膀胱癌组:红细胞数≤50/hp时,BTA中位值为67ng/ml,50/hp血尿浓度≤250/hp时,BTA中位值为118ng/ml,组间差别有统计学意义(P0.000)。血尿程度相近时膀胱癌组BTA表达水平与血尿模型组差别有统计学意义(P0.05)。结论尿BTA检测对膀胱癌的早期诊断和跟踪随访有较高的临床应用价值,并且有助于膀胱癌的早期筛查。但应注意浓血尿对检测结果的放大作用。
[Abstract]:Objective to investigate the clinical value of urinary bladder tumor antigen (BTAA) and the effect of hematuria on detection.Method 1.The first part of the study was divided into three groups, including 46 cases of bladder cancer and 35 cases of urinary tract benign diseases and 10 cases of healthy people, which were divided into bladder cancer group, benign disease group and healthy control group.Urine exfoliative cytology and BTA detection were performed in all groups.The second part of the experiment was divided into two groups: hematuria model group and bladder cancer group.To design a hematuria model: ten healthy people were included in the study, the urine 50ml and autologous blood were collected from 10 healthy subjects. The blood samples of each healthy person were mixed with 10 ml autologous urine, and 5 different proportions of hematuria were made.50 patients with bladder cancer were treated with fresh morning urine. The concentration of hematuria in the two groups was observed under high power microscope and the content of BTA in each sample was determined by ELISA method.Results the AUC of 1.BTA was 0.863n 95% confidence interval was 0.759U 0.924, the AUC of urine cytology was 0.670v 95% confidence interval was 0.5500.7750.The difference of AUC between the two groups was statistically significant.The expression and sensitivity of BTA in bladder cancer group were significantly higher than those in benign disease group and healthy group.There was no significant difference between the BTA expression level of recurrent bladder cancer and that of primary bladder cancer. The sensitivity of BTA in all stages of bladder cancer was higher than that of urine cytology in early stage of bladder cancer (Ta-T1).The difference between the healthy group and the control group was statistically significant (P 0.01).In the hematuria model group, there was a positive correlation between serum urine concentration and BTA content.In bladder cancer group, the median value of BTA when erythrocyte number 鈮，

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