免疫细胞检测和尿细胞学检查与其他尿液检查在膀胱癌检测和监测中的比较。
Comparison of the ImmunoCyt test and urinary cytology with other urine tests in the detection and surveillance of bladder cancer.
作者信息
Toma Marieta I, Friedrich Martin G, Hautmann Stefan H, Jäkel K Thorsten, Erbersdobler Andreas, Hellstern Angelika, Huland Hartwig
机构信息
Department of Urology, University of Hamburg, University Hospital Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.
出版信息
World J Urol. 2004 Jun;22(2):145-9. doi: 10.1007/s00345-003-0390-8. Epub 2004 Feb 27.
Despite several new urine markers urinary cytology remains the gold standard for the non-invasive detection of bladder carcinoma. The use of monoclonal antibodies against tumor associated antigens offers a promising approach to improve urinary cytology. The aim of this study was to compare fluorescence immunocytology (ImmunoCyt/Ucyt+ test), alone and in combination with the conventional cytology, with other urine markers. Urine samples from 126 patients undergoing cystoscopy were included in the study. Among them, 42 patients had urothelial carcinoma, two dysplasia, two other malignancies, and 78 had no evidence of bladder cancer. Urine samples were taken before any manipulation. We used the ImmunoCyt test and Papanicolaou staining for conventional cytology. The ImmunoCyt slides were examined under a fluorescence microscope. Evaluations of the tests were blinded to clinical and pathological data and were carried out by three independent observers. The results of cytology and ImmunoCyt were compared with the BTAstat, NMP22, Lewis X, 486p3/12, and Urovision tests. The sensitivity for the ImmunoCyt test was 78.3% and for conventional cytology 84.6%. The combination of ImmunoCyt and cytology showed a sensitivity of 89.1%. The specificity was 73.8% for the ImmunoCyt alone, 80.0% for the cytology, and 72.5% for the combination of ImmunoCyt and cytology. Sensitivities for the other tests were 68.8% for (FISH), 66.6% (BTA-Stat), 68.8% (486p3/12), 95.5% (Lewis X), and 71.1% for (NMP22). Specificity was 89.1% for (FISH), 78.2% (BTA-Stat), 76.4% (486p3/12), 32.8% (Lewis X), and 65.5% for (NMP22). Urinary cytology can be improved by immunostaining with monoclonal antibodies against tumor-associated antibodies. The combination of ImmunoCyt with conventional cytology offers a superior sensitivity to other commercial tests. The ImmunoCyt test provides a useful supplement to urinary cytology in the diagnosis of bladder cancer.
尽管有几种新的尿液标志物，但尿细胞学检查仍然是膀胱癌无创检测的金标准。使用针对肿瘤相关抗原的单克隆抗体为改善尿细胞学检查提供了一种有前景的方法。本研究的目的是比较荧光免疫细胞学检查（免疫细胞/尿细胞+检测）单独及与传统细胞学检查联合使用时，与其他尿液标志物的差异。本研究纳入了126例接受膀胱镜检查患者的尿液样本。其中，42例患者患有尿路上皮癌，2例发育异常，2例患有其他恶性肿瘤，78例无膀胱癌证据。在进行任何操作之前采集尿液样本。我们使用免疫细胞检测和巴氏染色进行传统细胞学检查。免疫细胞检测玻片在荧光显微镜下检查。检测评估对临床和病理数据保密，由三名独立观察者进行。将细胞学检查和免疫细胞检测结果与BTAstat、NMP22、Lewis X、486p3/12和Urovision检测结果进行比较。免疫细胞检测的敏感性为78.3%，传统细胞学检查为84.6%。免疫细胞检测与细胞学检查联合使用时敏感性为89.1%。单独免疫细胞检测的特异性为73.8%，细胞学检查为80.0%，免疫细胞检测与细胞学检查联合使用时为72.5%。其他检测的敏感性分别为：荧光原位杂交（FISH）68.8%、BTA-Stat 66.6%、486p3/12 68.8%、Lewis X 95.5%、NMP22 71.1%。特异性分别为：FISH 89.1%、BTA-Stat 78.2%、486p3/12 76.4%、Lewis X 32.8%、NMP22 65.5%。通过用针对肿瘤相关抗体的单克隆抗体进行免疫染色可以改善尿细胞学检查。免疫细胞检测与传统细胞学检查联合使用对其他商业检测具有更高的敏感性。免疫细胞检测为膀胱癌诊断中的尿细胞学检查提供了有用的补充。
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