el-Ahmady O, Halim A B, el-Din A G
Biochemistry Department, Faculty of Pharmacy, Al-Azhar Univ., Nasr City, Cairo, Egypt.
Anticancer Res. 1999 Jul-Aug;19(4A):2603-8.
There are a wide variety of tumor markers now available that proved to be of value in the management of cancer patients. Of these markers, tissue polypeptide antigen (TPA) and tissue polypeptide specific antigen (TPS) are well known in the field of bladder cancer. TPA was found to be a mixture of cytokeratins 8, 18 and 19 and recent investigations proved that TPS is keratin 18. The aim of the present study was to assess the clinical value of urinary cytokeratin 19 (CYFRA21-1) in the differential diagnosis between bladder cancer and benign urinary tract diseases represented by bilharziasis. Two hundreds and seventy individuals were included in the present study: 186 with bladder cancer representing the different stages and grades, 44 with urinary tract bilharziasis and 40 normal healthy controls. CYFRA21-1 was evaluated in 24-hour urine samples by ELISA using the automatic set supplied by Boehringer Manheim, Manheim, Germany (ES 300). Results of this study revealed significant elevation of CYFRA21-1 in bladder cancer followed by bilharziasis. 82.3% (153/186) of bladder cancer patients and 11.4% (5/44) of bilharzial patients exhibited CYFRA21-1 levels above the upper limit of the control group (3 micrograms/24-hr). CYFRA21-1 was more sensitive in advanced than early stages of bladder cancer and in patients with positive than those with negative lymph nodes, but association of tumor with bilharziasis did not markedly affect its level.
目前有各种各样的肿瘤标志物，它们在癌症患者的管理中被证明具有价值。在这些标志物中，组织多肽抗原（TPA）和组织多肽特异性抗原（TPS）在膀胱癌领域广为人知。TPA被发现是细胞角蛋白8、18和19的混合物，最近的研究证明TPS是角蛋白18。本研究的目的是评估尿细胞角蛋白19（CYFRA21-1）在膀胱癌与以血吸虫病为代表的良性泌尿系统疾病鉴别诊断中的临床价值。本研究纳入了270名个体：186例患有代表不同分期和分级的膀胱癌，44例患有泌尿系统血吸虫病，40例为正常健康对照。使用德国曼海姆宝灵曼公司提供的自动检测设备（ES 300），通过酶联免疫吸附测定法（ELISA）在24小时尿液样本中评估CYFRA21-1。本研究结果显示，CYFRA2在膀胱癌患者中显著升高，其次是血吸虫病患者。82.3%（153/186）的膀胱癌患者和11.4%（5/44）的血吸虫病患者CYFRA21-1水平高于对照组上限（3微克/24小时）。CYFRA21-1在膀胱癌晚期比早期更敏感，在有阳性淋巴结的患者中比阴性淋巴结患者更敏感，但肿瘤与血吸虫病的关联并未明显影响其水平。
