尿纤维连接蛋白在诊断上尿路移行细胞癌临床意义

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1、尿纤维连接蛋白在诊断上尿路移行细胞癌临床意义作者：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，并同时测定尿肌酉干(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

2、正常人(14.7±8.8)mg/mol及其它泌尿系疾病患者(28.2+22.7)mg/molo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%O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(P>；O.05)o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

3、肌肝比值；上尿路；移行细胞癌【ABSTRACT]Objective：Toinvestigatethebiologicalrelationshipbetweenurinefibronectin(Fn)andupperurinarytracttransitionalcellcareinoma(TCC)inpatients.Methods：UrinaryFnwasdetectedbyELISAtechniquein30caseswithupperurinarytractTCC,24caseswithotherurogenitaldiseasesand19health

4、ysubjects・Meanwhiletheanalysisforcreatin(Cr)inurinewascarriedoutandtheFn/Crratiowascalculated.ThediscrepancyofurinaryFn/Cramongthreegroupsandtumorgradesandstageswasanalizedaswel1.SensitivityandspecificityoftheurinaryFn/Crwerecomparedwiththatoftheurinarycytology.Results：TheurinaryFn/

5、CrratiowassignificantlyhigherinupperurinarytractTCC(46.4±26・5mg/niol)thaninotherurogenitaldiseases(28・2±22・7mg/mol)andthehealthysubjects(14.7±8.8mg/mol)(P<；0.01,P<；0.05).Taking34mg/molforFn/Crasstandard,ThesensitivityandspecificityofurinaryFn/Crratiowere73.3%and77.8%respectively

6、.UrinaryFn/Crratiohadobviousdiscrepantamongtumorgradesandstages(P&It；0.01).Otherwise,thesensitivitywas53.3%forurinarycytology.Conclusions:UrinaryFn/CrratiohassignificantdiagnosticvalueinthepatientswithupperurinarytractTCC・ObviousrelationshipbetweenurinaryFn/Crandthestagesorgradeshas

7、beennoted.DeterminingurinaryFnvaluesmaygiveanideaabouttheinvasivepotentialofthetumorandmayestimatetheprognosis・【KEYWORDS】Urinaryfibronectin；Urinaryfibronectin/urinarycreatinvalue；Upperurinarytract；Transitionalcellcarcinoma上尿路移行细胞癌中基底膜Fn有不同程度丧失，这样使尿液中Fn含量有所变化。Fn在诊断膀胱癌并估测预后的意义已有相关报道［1

8、〜3］。本实验拟通过检测尿Fn含量在上