Lokeshwar V B, Block N L
Department of Urology, University of Miami School of Medicine, Florida, USA.
Urol Clin North Am. 2000 Feb;27(1):53-61. doi: 10.1016/s0094-0143(05)70234-2.
Hyaluronic acid and HAase are intricately associated with the biology of bladder tumor angiogenesis and metastasis. Tumor-associated HA and HAase are secreted in urine. In G2 and G3 bladder tumors, HA is degraded by HAase, resulting in the generation of angiogenic HA fragments, which, in turn, are secreted in urine. An elevated urinary HA level (> or = 500 ng/mg), indicating a positive HA test, suggests the presence of bladder cancer regardless of tumor grade. The urinary HAase levels correlate with the malignant potential of bladder cancer and are elevated (> or = 10 mU/mg) in the urine of patients with G2 and G3 bladder cancer. Combining the results from the HA and the HAase tests (the HA-HAase test) yields inferences, including the detection of bladder cancer and the evaluation of its grade. The overall 92% sensitivity of the HA-HAase test to detect bladder cancer is higher than the sensitivity of individual tests with little compromise in specificity. The HA-HAase test is equally sensitive for monitoring tumor recurrence. When compared with existing noninvasive tests, the HA-HAase test may be significantly less expensive and more accurate.
透明质酸（HA）和透明质酸酶（HAase）与膀胱肿瘤血管生成及转移的生物学过程密切相关。肿瘤相关的HA和HAase会分泌到尿液中。在G2和G3级膀胱肿瘤中，HA会被HAase降解，从而产生促血管生成的HA片段，这些片段继而分泌到尿液中。尿HA水平升高（≥500 ng/mg），即HA检测呈阳性，提示存在膀胱癌，而与肿瘤分级无关。尿HAase水平与膀胱癌的恶性潜能相关，在G2和G3级膀胱癌患者的尿液中升高（≥10 mU/mg）。结合HA和HAase检测结果（HA-HAase检测）可得出推论，包括膀胱癌的检测及其分级评估。HA-HAase检测对膀胱癌检测的总体敏感性为92%，高于单项检测的敏感性，且特异性几乎没有损失。HA-HAase检测对监测肿瘤复发同样敏感。与现有的非侵入性检测相比，HA-HAase检测可能成本显著更低且更准确。
