尿纤维连接蛋白在诊断上尿路移行细胞癌的临床意义_临床医学论文.docVIP

尿纤维连接蛋白在诊断上尿路移行细胞癌的临床意义_临床医学论文 尿纤维连接蛋白在诊断上尿路移行细胞癌的临床意义_临床医学论文 作者：凌海滨 赵莹 李向东 苗文隆 李凤歧 成日青 【摘要】 目的: 探讨尿纤维连接蛋白(fibronectin,Fn)与上尿路移行细胞癌的生物学关系。方法: 采用ELISA法检测30例上尿路移行细胞癌、25例其它泌尿系疾病患者及20例正常人尿液Fn含量，并同时测定尿肌酐（Creatin,Cr），计算Fn/Cr比值，比较各组人群尿Fn/Cr比值之间的差异；分析不同肿瘤分期、分级尿Fn/Cr之间的差异；比较其与尿脱落细胞学检测上尿路移行细胞癌的敏感性。结果: 上尿路移行细胞癌尿Fn/Cr比值为（46.4±26.5）mg/mol，明显高于正常人（14.7±8.8）mg/mol及其它泌尿系疾病患者（28.2±22.7）mg/mol。以34mg/mol为标准，尿Fn/Cr比值诊断上尿路移行细胞癌的灵敏度和特异度分别为73.3%和77.8%。尿Fn/Cr比值与上尿路肿瘤分期分级有关。尿脱落细胞学检测上尿路移行细胞癌的敏感性为53.3%，采用Fn/Cr检测较脱落细胞学检查敏感性无统计学意义（Pgt;0.05）。结论: 尿Fn/Cr可作为上尿路移行细胞癌的诊断指标。其高低与膀胱癌的分期、分级有关，可大致判断浸润度和恶性度，并可用于上尿路移行细胞癌的预后评估。 【关键词】 尿纤维连接蛋白; 尿纤维连接蛋白/尿肌酐比值; 上尿路; 移行细胞癌 【ABSTRACT】 Objective: To investigate the biological relationship between urine fibronectin (Fn) and upnts. Methods：Urinary Fn was detected by ELISA technique in 30 cases with upper urinary tract TCC, 24 cases with other urogenital diseases and 19 healthy subjects. Meanwhile the analysis for creatin (Cr) in urine was carried out and the Fn/Cr ratio was calculated. The discrepancy of urinary Fn/Cr among three groups and tumor grades and stages was analized as well. Sensitivity and specificity of the urinary Fn/Cr were compared with that of the urinary cytology. Results：The urinary Fn/Cr ratio was significantly higher in upper urinary tract TCC (46.4±26.5mg/mol)than in other urogenital diseases (28.2±22.7mg/mol)and the healthy subjects (14.7±8.8mg/mol) (0.01, 0.05). Taking 34mg/mol for Fn/Cr as standard, The sensitivity and specificity of urinary Fn/Cr ratio were 73.3% and 77.8% respectively. Urinary Fn/Cr ratio had obvious discrepant among tumor grades and stages (0.01). Otherwise,the sensitivity was 53.3% for urinary cytology. Conclusions： Urinary Fn/Cr ratio has significant diagnostic value in the patients with upper urinary tract TCC. Obvious relationship between urinary Fn/Cr and the stages or grades has been noted. Determining urinary Fn values may give an idea about the invasive potential of the tumor and may estimate the prognosis. 【KEY