Hakenberg Oliver W, Fuessel Susanne, Richter Katja, Froehner Michael, Oehlschlaeger Sven, Rathert Peter, Meye Axel, Wirth Manfred P
Department of Urology, Universitätsklinikum Carl Gustav Carus, Dresden, Germany.
Urology. 2004 Dec;64(6):1121-6. doi: 10.1016/j.urology.2004.08.019.
To evaluate the value of urine tests based on the detection of cytokeratins 8 and 18 for the diagnosis of bladder cancer compared with urine cytology.
Samples from 112 patients before transurethral resection (group 1), 40 patients before secondary surgical treatment (group 2), 29 healthy control subjects (group 3, controls), and 10 women with acute urinary tract infection (group 4, controls) were examined with the UBC Rapid and UBC II enzyme-linked immunosorbent assay (ELISA) tests and voided urine cytology.
Of the 112 patients in group 1, 90 had transitional cell carcinoma. For the UBC Rapid, UBC ELISA, and cytology, the sensitivity and specificity was 64.4%, 46.6%, and 70.5% and 63.6%, 86.3%, and 79.5%, respectively. The cytology had the greatest accuracy (72.3%) compared with both cytokeratin tests (54.4% and 64.2%). For all three tests, sensitivity increased with tumor grade and stage. In group 2, 16 of 40 patients had residual carcinoma. The sensitivity was similar for all three tests, and the specificity of cytology was lower compared with its specificity in group 1 (47.9% versus 70.5% in group 1). In the controls with or without urinary tract infection, the specificity of cytology was greater than that of both other tests. The combination of the UBC ELISA test with cytology increased the sensitivity to 83% (specificity 68%).
Both cytokeratin tests detected patients with transitional cell carcinoma, but were inferior to voided urine cytology in test quality.
与尿液细胞学检查相比，评估基于细胞角蛋白8和18检测的尿液检查对膀胱癌诊断的价值。
对112例经尿道切除术前行手术的患者（第1组）、40例二次手术治疗前行手术的患者（第2组）、29例健康对照者（第3组，对照组）和10例急性尿路感染女性患者（第4组，对照组）的样本进行UBC快速检测和UBC II酶联免疫吸附测定（ELISA）以及晨尿细胞学检查。
第1组的112例患者中，90例患有移行细胞癌。对于UBC快速检测、UBC ELISA检测和细胞学检查，其敏感性和特异性分别为64.4%、46.6%、70.5%以及63.6%、86.3%、79.5%。与两种细胞角蛋白检测（54.4%和64.2%）相比，细胞学检查的准确性最高（72.3%）。对于所有三项检测，敏感性均随肿瘤分级和分期增加。第2组的40例患者中，16例有残留癌。所有三项检测的敏感性相似，与第1组相比，细胞学检查的特异性较低（第1组为70.5%，第2组为47.9%）。在有或无尿路感染的对照组中，细胞学检查的特异性高于其他两项检测。UBC ELISA检测与细胞学检查联合使用可将敏感性提高至83%（特异性为68%）。
两种细胞角蛋白检测均能检测出移行细胞癌患者，但在检测质量上不如晨尿细胞学检查。
