| Background:Urethral cancer(UC)is a tumor that originates in urothelial cells such as the renal pelvis,ureter,bladder,and urethra.It mainly includes upper urothelial cell carcinoma(UTUC)and bladder cancer(BC).At present,the diagnosis and monitoring methods of UC are mainly based on routine imaging examinations such as urine cytology,cystoscopy and CT.The diagnostic accuracy of urinary shedding cytology and routine imaging is poor,and cystoscopy is costly and the patient's compliance is poor.A reasonable method for the reasonable detection of UC is urgently needed.Urine-based biomarkers are convenient and non-invasive to help improve UC diagnosis.BLCA-4 is a nuclear matrix protein that has the highest sensitivity and specificity among the currently reported markers of bladder cancer,and can be expressed in the early stages of bladder cancer.NMP22 is one of the tumor markers approved by the FDA for the diagnosis of bladder cancer.UTUC and BC have the same cell origin.The two have common characteristics in many aspects.Theoretically,bladder cancer tumor markers can be used for the diagnosis of epithelial urothelial carcinoma.There are few reports of tumor markers for UTUC.In this study,we explored the value of BLCA-4,NMP22,and urinary shedding cytology in the early diagnosis of urothelial carcinoma.Objective:To discuss the significance of bladder cancer-specific nuclear matrix protein-4(BLCA-4),nuclear matrix protein 22(NMP22),and urinary shedding cytology in the diagnosis of urothelial carcinoma,and to provide early noninvasive detection of urothelial carcinoma.Theoretical basis.Methods:1.A total of 146 clinical urine specimens were collected from the affiliated hospital of Qingdao University from December 2018 to June 2019,of which 96 were in the urothelial cancer group,including 70 patients with primary bladder cancer.Twenty-six patients with urothelial carcinoma and 50 negative controls included 30 patients with interference disease and 20 healthy people.2.Collect 50 ml urine samples of all patients and group them.One group is used for BLCA-4 test and the other is used for NMP22 test.In addition,300 ml non-morning urine samples of patients with urothelial cancer and interference disease are collected.For urinary shedding cytology.3.Use spss24.0 software to draw the receiver operating curve(ROC),analyze the significance of BLCA-4,NMP22 and urine exfoliation cytology in the diagnosis of UTUC and BC alone,and use the Chi-square test or fee-based exact probability to send the analysis marker and The relationship between the patient's pathological grade and the period.4.Discuss the value of combined detection of markers and urine shedding cytology in the diagnosis of UC.Results:1.The expressions of BLCA-4 and NMP22 were higher in the UTUC group and the BC group than in the negative control group(B: P <0.001,P <0.001;N: P <0.001,P <0.001).2.Among the three detection methods,BLCA-4 has the highest diagnostic accuracy.In the diagnosis of urothelial carcinoma,the sensitivity is 88.54%,the specificity is 94%,and the ROC-AUC is 0.932(95% CI: 0.905 ? 0.959).).3.BLCA-4 and NMP22 positive rates were not significantly different in different pathological grades and stages of urothelial carcinoma(P> 0.05).4.BLCA-4 combined with exfoliated urinary cell examination has the highest diagnostic efficacy.The AUC is 0.949(95% CI: 0.905 ? 0.994),the sensitivity is 95.83%,the specificity is 94%,and the diagnostic accuracy is 95.21%.Conclusion: BLCA-4 and NMP22 as tumor markers not only have diagnostic value in early diagnosis of bladder cancer,but also have potential diagnostic value in upper urothelial cancer.They can be used as biomarkers for early noninvasive detection of urothelial cancer.Potential clinical application prospects.BLCA-4 combined with urinary shedding cytology is of great significance in detecting urothelial carcinoma. |
PDF Full Text Request