尿液中核基质蛋白22联合端粒酶活性检测在膀胱癌诊断中的作用

目的探讨尿液中核基质蛋白22（NMP22）联合端粒酶活性检测在膀胱癌诊断中的价值。方法收集38例膀胱癌和28例非膀胱癌患者新鲜尿液，用化学发光分析法检测尿NMP22水平，TRAP—PCR-ELISA法检测尿脱落细胞端粒酶活性，并同时行尿脱落细胞学检查。结果尿液中NMP22对膀胱癌诊断的敏感性为79％，特异性为64％；端粒酶敏感性为82％，特异性为71％；细胞学检查敏感性为32％，特异性为97％。NMP22联合端粒酶活性检测，两者均为阳性时诊断为阳性，否则为阴性，则联合检测的敏感性为76％，特异性为89％。结论联合检测可使在维持较高敏感性的前提下，大大提高诊断的特异性，其特异性与细胞学检测相差较小，而敏感性却远高于细胞学检测，因而联合检测较单一指标的检测对膀胱癌具有更高的诊断价值。

The value of combined urinary NMP22 and telomerase test for diagnosis of bladder

Objective To explore the value of combined urinary NMP22 and telomerase test for diagnosis of bladder. Methods Urinary NMP level and telomerase activity of 38 cases of bladder cancer and 28 cases of non-bladder cancer were determined by chemiluminescent assay and TRAP-PCR-ELISA assay respectively; meanwhile cytological examination was performed. Results The sensitivity of cancer was 70%for NMP22,82%for telomerase, 33 % for cytology;the specificity of cancer was 64%for NMP22,71%for telomerase, 97% for cytology. In the combined test of NMP22 and telomerase,positive was defined as both positive in NMP22 test and telomearase test, otherwise negative. Then the sensitivity was 76% and the specificity was 89%for combined detection. Conclusions In the population tested,combined urinary NMP22 and telomerase test showed greater sensitivity than conventional cytology, and remained similar specificity as cytology. The combination of urinary NMP22 and telomerase test was more valuable for diagnosis of bladder cancer than single assay.