The Significance Of Urinary Bladder Tumor Antigen-Expression In Bladder Cancer And Its Influencing Factors Of Detection

【objective】To explore the clinical value of urinary bladder tumor antigen and the effect of hematuria on the detection.【Methods】1.The first part of the study has three groups,including 46 bladder cancer patients 、35 urological benign disease patients.another 10 normal individuals were enrolled in this study.all subjects were received urine BTA assay and urinary cytology before cystoscope test.Cystoscopy result was the standard of detection..Urine BTA was assesed by enzyme-linked immuno sorbent assay(ELISA)before cystoscopy.we assess the sensitivity、specificity、respectively predictive values,positive predictive values of the two tests in the study.2.The second part of the experiment has two groups:Bladder cancer group and hematuria model group.To design hematuria model group,10 healthy subjects provided urine and blood samples for the study,none of subjects had any urological disorder,normal urine was mixed with autologous blood to cause hematuria of 5 degrees of severity.Bladder cancer group is 50 fresh urine samples of bladder cancer patients before invasive procedures.The number of red blood cells was determined by microscopic examination in each urine sample of the two groups to represent the degree of hematuria.Each urine samples are analyzed by ELISA to measure BTA content.【Results】1.the sensitivity 、specificity、false positive rate of BTA test were 86.9%、82.2%、17.8%,95%CI(0.759 、0.924);the sensitivity 、specificity、false positive rate of cytology test were 34.7%、97.8%、2.2%,95%CI(0.550、0.775),the sensitivity of BTA were significantly better than urinary cytology test;2.The median of BTA was as follows: bladder cancer patients 181.8ng/mL,urological benign disease patients 28.7 ng/mL and normal(healthy)individuals 1.3 ng/mL,The first was more than the later two(P<0.01);3.The expression level of BTA and sensitivity were related to tumor stage、grade and hematuria degree(P<0.01),Irrelevant to relapse or initial cancer(P>0.05).The sensitivity of BTA in diagnosis of each grade and stage of bladder cancer were higher than urinary cytology(P<0.01);3 、 The level of BTA in non-invasive urothelial carcinoma was significantly higher than that in healthy group and benign disease group(P<0.01).4.Hematuria concentration and BTA content is positively correlated in hematuria model group(rs=0.98).When hematuria degree is similar,the BTA content in bladder cancer group was significantly higher than that in hematuria model group(P <0.05)【Conclusions】Urinary BTA expression has a high clinical value in bladder cancer diagnosis、follow-up,and contribute to the early screening of bladder cancer,but should note the hematuria can amplify BTA bladder cancer detection value.