膀胱肿瘤相关抗原在膀胱癌患者尿液中的表达及其意义

发布时间：2019-05-27 16:56

【摘要】：目的:分析膀胱肿瘤相关抗原(BTAA)在膀胱尿路上皮癌患者晨尿(术前)中及泌尿系统非尿路上皮癌患者晨尿中表达的差异性;不同病理级别膀胱尿路上皮癌患者晨尿(术前)中表达的差异性;从而应用于膀胱尿路上皮癌患者的早期筛查和术后随访。方法:病例分为2组,第一组为(病例组):2015年11月至2016年11月青海大学附属医院膀胱肿瘤患者术前晨尿共计97例,应用BTAA定量测定试剂盒(北京普恩光德)检测该患者尿液中BTAA表达情况,术后5例病理结果不是膀胱尿路上皮癌,排除在外,对92例进行统计学分析;第二组为(对照组):泌尿系统非膀胱尿路上皮癌患者及正常健康人群尿液共计57例,同样应用上述方法进行检测,作为对照。样本浓度88ng/ml认定为阳性结果。应用特异度、灵敏度及卡方检验(P0.05有统计学意义)分析BTAA在上述两组之间及不同病理级别膀胱尿路上皮癌患者晨尿中表达差异性。结果:1、比较两组的阳性率:P0.05,差异有统计学意义,说明BTAA在病例组及对照组表达的阳性率不等,病例组BTAA阳性表达率明显高于对照组;2、BTAA表达的总体特异度为:82.4%;总体灵敏度为:80.4%;3、比较不同病理级别膀胱尿路上皮癌的阳性率:P0.05,差异有统计学意义,说明不同级别膀胱尿路上皮癌BTAA表达的阳性率不相等,高病理级别膀胱癌BTAA表达的阳性率比低病理级别膀胱癌BTAA表达的阳性率高;4、低度恶性潜能尿路上皮肿瘤、低级别尿路上皮癌、高级别尿路上皮癌BTAA表达的灵敏度分别为:60.0%、88.9%、92.3%。结论:1、膀胱肿瘤相关抗原在膀胱尿路上皮癌及泌尿系统非尿路上皮癌患者的尿液中表达有差异,病例组BTAA表达的阳性率明显高于对照组。2、BTAA在不同病理级别膀胱尿路上皮癌表达有差异,高病理级别膀胱癌BTAA表达的阳性率比低病理级别膀胱癌BTAA表达的阳性率高。3、BTAA具有灵敏度高及特异性强等特点,可作为膀胱尿路上皮癌患者的早期筛查和术后随访的无创性手段。
[Abstract]:Objective: to analyze the expression of bladder tumor associated antigen (BTAA) in morning urine of patients with bladder urothelial carcinoma (before operation) and in morning urine of patients with non-urinary epithelial carcinoma of urinary system. The difference of expression in morning urine (before operation) in patients with different pathological grades of bladder urothelial carcinoma was applied to early screening and postoperative follow-up of patients with bladder urothelial carcinoma. Methods: the cases were divided into two groups. The first group was (case group): from November 2015 to November 2016, 97 patients with bladder tumor in the affiliated Hospital of Qinghai University had morning urine before operation. The expression of BTAA in urine was detected by BTAA kit (Beijing Pun Guangde). The pathological results of 5 cases were not bladder urothelial carcinoma after operation. 92 cases were statistically analyzed. The second group (control group): a total of 57 patients with non-bladder urothelial carcinoma of the urinary system and normal healthy people were also detected by the above methods as control. The sample concentration 88ng/ml was identified as positive. Specificity, sensitivity and chi-square test (P 0.05) were used to analyze the expression of BTAA in morning urine of patients with bladder urothelial carcinoma of the above two groups and different pathological grades. Results: 1. The positive rate of BTAA in the case group and the control group was significantly higher than that in the control group. The positive rate of BTAA in the case group was significantly higher than that in the control group. 2, the overall specificity and sensitivity of BTAA expression were 82.4%, 80.4%, 80.4%, 82.4%, 80.4%, 82.4%, 80.4%, 82.4% and 80.4%, respectively. 3. The positive rate of different pathological grades of bladder urothelial carcinoma was compared: P0.05, the difference was statistically significant, indicating that the positive rate of BTAA expression in different grades of bladder urothelial carcinoma was not equal. The positive rate of BTAA expression in high pathological grade bladder cancer was higher than that in low pathological grade bladder cancer. 4. the sensitivity of BTAA expression in low malignant potential urinary epithelial tumors, low grade urinary epithelial carcinoma and high grade urinary epithelial carcinoma was 60.0%, 88.9% and 92.3%, respectively. Conclusion: 1. The expression of bladder tumor associated antigen in urine of patients with bladder urothelial carcinoma and non-urinary epithelial carcinoma of urinary system is different. The positive rate of BTAA expression in the case group is significantly higher than that in the control group. 2. The positive rate of BTAA expression in high pathological grade bladder cancer was higher than that in low pathological grade bladder cancer. 3 the positive rate of BTAA expression in high pathological grade bladder cancer was higher than that in low pathological grade bladder cancer. It can be used as a noninvasive method for early screening and postoperative follow-up of patients with bladder urothelial cancer.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.14

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