Wunderlich H, Reichelt O, Zermann D H, Schubert J, Berndt A, Kosmehl H
Department of Urology, Friedrich-Schiller-University, D-07740 Jena, Germany.
Oncol Rep. 2001 May-Jun;8(3):669-72. doi: 10.3892/or.8.3.669.
Early detection of transitional cell carcinoma (TCC) of the urinary bladder is essential for effective treatment. While several serum markers have been evaluated, none have been widely accepted for practical clinical use. Thus, urinary markers have been introduced and investigated to detect the evidence of bladder cancer. But sensitivity and specificity range around 80% respectively. In a prospective study we evaluated fetal fibronectin in the urine of patients with TCC of the urinary bladder. The positivity of oncofetal fibronectin was measured in morning urine samples by membrane immunoassay. This FFN membrane immunoassay is a qualitative test, a solid-phase immunogold assay. A positive sample will result in a single spot after binding of the oncofetal fibronectin-immunogold complex to the membrane containing a monoclonal antibody specific to oncofetal fibronectin (FDC-6, which specifically recognizes III-CS region). The morning urine samples were collected from patients with TCC before they underwent transurethral resection (n=40, 34 non-invasive and 6 invasive carcinomas) and healthy controls (n=20). Oncofetal fibronectin was investigated in the surgical samples by immunohistochemistry (antibody FDC-6, APAAP technique). We found a positive result for oncofetal fibronectin in 38/40 patients with transitional cell carcinoma of the urinary bladder. Two patients with a small pTaG1-TCC showed negative results. In the urine of healthy controls no positive results were detected. Thus, there is a sensitivity of 95% and a specificity of 100%. The TCC was demonstrated as a source of oncfn. To our knowledge this is the first study showing that patients with an evident TCC have a demonstrable amount of oncofetal fibronectin in the urine. We conclude that a positive result is common in TCC-patients. The sensitivity and specificity of this test seems to be extraordinarily high. Because of the small number of cases further studies are required.
早期发现膀胱移行细胞癌（TCC）对于有效治疗至关重要。虽然已经评估了几种血清标志物，但尚无一种被广泛接受用于实际临床应用。因此，人们引入并研究了尿液标志物以检测膀胱癌的证据。但其敏感性和特异性分别在80%左右。在一项前瞻性研究中，我们评估了膀胱TCC患者尿液中的胎儿纤连蛋白。通过膜免疫测定法测量晨尿样本中癌胚纤连蛋白的阳性率。这种FFN膜免疫测定法是一种定性测试，即固相免疫金测定法。癌胚纤连蛋白 - 免疫金复合物与含有癌胚纤连蛋白特异性单克隆抗体（FDC - 6，它能特异性识别III - CS区域）的膜结合后，阳性样本会产生一个斑点。从膀胱TCC患者经尿道切除术前（n = 40，其中34例为非浸润性癌，6例为浸润性癌）以及健康对照者（n = 20）收集晨尿样本。通过免疫组织化学（抗体FDC - 6，APAAP技术）在手术样本中研究癌胚纤连蛋白。我们发现40例膀胱移行细胞癌患者中有38例癌胚纤连蛋白检测呈阳性。两名患有小的pTaG1 - TCC的患者检测结果为阴性。在健康对照者的尿液中未检测到阳性结果。因此，敏感性为95%，特异性为100%。TCC被证明是癌胚纤连蛋白的来源。据我们所知，这是第一项表明明显患有TCC的患者尿液中存在可检测量癌胚纤连蛋白的研究。我们得出结论，TCC患者中阳性结果很常见。该测试的敏感性和特异性似乎非常高。由于病例数量较少，需要进一步研究。
