膀胱尿路上皮癌患者外周血CK20、CD105及CD146表达的临床意义

目的检测膀胱尿路上皮癌患者外周血中血清肿瘤标志物CK20、CD105和CD146的表达,探讨CK20、CD105和CD146作为膀胱尿路上皮癌微转移指标的应用价值。方法采用流式细胞仪检测50例膀胱尿路上皮癌患者、30例健康志愿者外周血中CK20及CD105/CD146的表达情况。分析膀胱尿路上皮癌患者外周血中CK20及CD105/CD146的阳性表达率及其与临床病理学指标的关系;CK20及CD105/CD146在膀胱尿路上皮癌患者外周血中表达的相关性及联合检测的意义。结果CK20和CD105/CD146在膀胱癌组中的阳性表达率分别为28.0%和48.0%,其表达与肿瘤分期、病理分级、有无远处转移、肿瘤直径、病灶数量等相关（P〈0.05）,而与患者性别、年龄无相关性（P〉0.05）。患者中有10例同时出现CK20及CD105/CD146阳性表达,两者的表达有相关性（χ2=4.276,r=0.281,P〈0.05）。联合检测与单独检测CK20相比,阳性率有所提高,差异有统计学意义（P=0.005）;联合检测与单独检测CD105/CD146相比,阳性率差异无统计学意义（P=0.423）,但阳性率仍有提高。结论CK20及CD105/CD146对于预测膀胱尿路上皮癌微转移具有较高的敏感性。联合检测CK20及CD105/CD146与单项检测相比,具有更高的敏感性。CK20及CD105/CD146可以作为膀胱尿路上皮癌微转移早期诊断、早期治疗和预后判断的生物学指标。

The expression of CK20, CD105 and CD146 in peripheral blood from patients with urothelial carcinoma of bladder

Objective To detected the expression of CK20,CD105 and CD146 in peripheral blood of patients with urothelial carcinoma of bladder and evaluate the value of CK20,CD105 and CD146 as tumor markers of micro-metastasis for urothelial carcinoma of bladder.Methods 50 cases of urothelial carcinoma of bladder and 30 cases of healthy volunteers were included.Our researches were to detect expression of CK20 and CD105/CD146 and then analyze the positive expression rate of CK20 and CD105/CD146 in the peripheral blood to decide the relationship with CK20,CD105/CD146 and clinicopathological parameters as well as their correlation.Results In urothelial carcinoma of bladder group,the positive rates of CK20 and CD105/CD146 were 28.0% and 48.0%.CK20 and CD105/CD146 were correlate with stage,histological grade,distant metastasis,tumor diameter,tumor volume significantly（P0.05）,but sex and age were not found to have any correlation（P0.05）.And the positive expression of CK20 correlated with CD105/CD106.Combined detection of these factors can promote the positive rate.Conclusions We conclude that these two markers of CK20 and CD105/CD146 for the detection of urothelial carcinoma of bladder micro-metastases have a high sensitivity.These markers can be used as biological indicators of micro-metastasis of urothelial carcinoma of bladder for early diagnosis and,in turn,early treatment and prognosis.The combined detection can give a rise of positive rate.