Mungan N A, Vriesema J L, Thomas C M, Kiemeney L A, Witjes J A
Department of Urology, University Medical Center, Nijmegen, The Netherlands.
Urology. 2000 Nov 1;56(5):787-92. doi: 10.1016/s0090-4295(00)00798-6.
To study the diagnostic performance of the Urinary Bladder Cancer (UBC) test in patients with superficial bladder carcinoma.
One hundred one patients in follow-up for superficial bladder cancer (pTa, pT1, carcinoma in situ) were recruited for this study. Each patient underwent cystoscopy and transurethral resection or biopsy, with subsequent histologic confirmation in the case of abnormalities. In addition, specimens were assessed with an immunoenzymometric assay for cytokeratin expression (the UBC test), and the urinary creatinine concentration was determined to correct for different degrees of urinary dilution. Different methods were applied to calculate the diagnostic value of the UBC test.
Both noncorrected and corrected median values of the UBC test were comparable between patients with and without a recurrent bladder tumor. The overall sensitivity, specificity, and positive and negative predictive values of the noncorrected UBC test was 20.7%, 84.7%, 35.3%, and 72.6%, respectively. For the corrected UBC test, the corresponding values were 20.7%, 79.2%, 28.6%, and 71.3%. The area under the receiver operating characteristic curve was not significantly different from 0.50, indicating no diagnostic value of the UBC test in this study.
The diagnostic value of this new urinary marker appears insufficient for the follow-up of patients with superficial bladder cancer.
研究尿膀胱癌（UBC）检测对浅表性膀胱癌患者的诊断效能。
本研究纳入101例接受浅表性膀胱癌（pTa、pT1、原位癌）随访的患者。每位患者均接受膀胱镜检查及经尿道切除术或活检，若发现异常则进行后续组织学确诊。此外，采用免疫酶测定法评估标本中的细胞角蛋白表达（UBC检测），并测定尿肌酐浓度以校正不同程度的尿液稀释。应用不同方法计算UBC检测的诊断价值。
有复发性膀胱肿瘤和无复发性膀胱肿瘤患者的UBC检测未校正和校正后的中位数相当。未校正的UBC检测的总体敏感性、特异性、阳性预测值和阴性预测值分别为20.7%、84.7%、35.3%和72.6%。校正后的UBC检测的相应值分别为20.7%、79.2%、28.6%和71.3%。受试者工作特征曲线下面积与0.50无显著差异，表明本研究中UBC检测无诊断价值。
这种新的尿液标志物对浅表性膀胱癌患者随访的诊断价值似乎不足。
