Dey Pranab
Department of Cytology, Post Graduate Institute of Medical Education, Chandigarh, India.
Clin Chim Acta. 2004 Feb;340(1-2):57-65. doi: 10.1016/j.cccn.2003.11.008.
Transitional cell carcinoma of bladder is one of the most common tumors of genitourinary tract. Cystoscopy along with cytology is the mainstay for diagnosing bladder cancer. Cytology is specific for diagnosis of bladder carcinomas but less sensitive particularly in low-grade disease. Cystoscopy on the other hand is invasive and relatively costly technique and may also be inconclusive at times particularly in case of cystitis. A simple noninvasive marker for detecting bladder cancer would be helpful. A clinically useful urinary marker should be easy to perform, should have minimum requirements for sample preparations and should have high sensitivity and specificity in diagnosis. In this review we discussed the various urinary markers and their role in detection of bladder cancer.
We reviewed the literature on urinary markers and tests that may have clinical usefulness.
Several urinary markers and tests such as BTA Stat, BTA TRAK, NMP22, telomerase, HA and HAse tests, Immunocyt, Quanticyt, FDP, BLCA-4, FISH, CYFRA-21-1 have enough potential for future clinical use. BTA stat, NMP22 (bladder check)and AccuDX (FDP) tests are presently point of care tests. The rest of the tests are laboratory-based and may need trained technicians. Majorities of the urinary markers have higher sensitivity and specificity than cytology. However, voided urinary cytology has the highest specificity.
Till now there is no urinary marker or test that can replace the need of cystoscopy. However, some markers have the potential for future clinical use.
膀胱移行细胞癌是泌尿生殖道最常见的肿瘤之一。膀胱镜检查结合细胞学检查是诊断膀胱癌的主要方法。细胞学检查对膀胱癌的诊断具有特异性，但敏感性较低，尤其是在低级别疾病中。另一方面，膀胱镜检查是一种侵入性且相对昂贵的技术，有时也可能无法得出明确结论，特别是在膀胱炎的情况下。一种简单的非侵入性膀胱癌检测标志物将很有帮助。一种临床有用的尿液标志物应易于操作，对样本制备的要求应最低，并且在诊断中应具有高敏感性和特异性。在本综述中，我们讨论了各种尿液标志物及其在膀胱癌检测中的作用。
我们回顾了有关可能具有临床实用性的尿液标志物和检测方法的文献。
几种尿液标志物和检测方法，如BTA Stat、BTA TRAK、NMP22、端粒酶、透明质酸和透明质酸酶检测、免疫细胞检测、定量细胞检测、纤维蛋白降解产物（FDP）、BLCA - 4、荧光原位杂交（FISH）、细胞角蛋白19片段（CYFRA - 21 - 1）等，具有足够的潜力用于未来的临床应用。BTA stat、NMP22（膀胱检查）和AccuDX（FDP）检测目前是即时检验。其余检测方法基于实验室，可能需要训练有素的技术人员。大多数尿液标志物的敏感性和特异性高于细胞学检查。然而，尿脱落细胞学检查具有最高的特异性。
到目前为止，尚无尿液标志物或检测方法能够取代膀胱镜检查的需求。然而，一些标志物具有未来临床应用的潜力。
