Gacci Mauro, Serni Sergio, Lapini Alberto, Giubilei Gianluca, Dal Canto Maurizio, Paladini Sergio, Curotto Antonio, Gallo Fabrizio, Carmignani Giorgio, Carini Marco
Clinica Urologica, Università di Firenze.
Arch Ital Urol Androl. 2006 Mar;78(1):5-10.
The Urinary Bladder Cancer (UBC) test is a marker that detects urinary fragments of cytokeratin 8 and 18. The aim of this study is to evaluate the usefulness of the pre and post operative UBC test to detect early recurrences of a bladder tumor in the first year after the transurethral resection of a bladder tumor.
A multicentric perspective study on 36 patients with superficial bladder cancer (pTa-pT1) treated with transurethral resection (TUR) was performed. Each patient underwent 4 specific urine collections: 1) preoperatively, 2) 3 days after TUR, 3) 7 days after TUR, 4) 30 days after TUR. UBC was analysed on urine with the IRMA method and the cut off value of 12 mg/L was used. Cystoscopy was performed after 3, 6, 9, and 12 months after TUR, with the aim of identifying all cancer recurrences in the first year postoperatively. Statistical analyses to identify differences between patients with or without early recurrence were performed in accordance with Fisher's exact test and Chi-square analysis.
Of the 36 patients included in the study 15 showed early recurrence and 21 were recurrence free 1 year after surgery. UBC levels measured in recurrence free patients 30 days after TUR showed normal values, values decreasing as compared with preoperative levels or both circumstances, even if a statistically significant difference was not found between the two groups.
In this study we reported an insignificant correlation between the postoperative modifications of UBC levels and the risk of tumor recurrence during the first year of follow-up. A larger study group with longer follow-ups will probably allow better evaluation of the real power of UBC tests in clinical practice.
膀胱癌（UBC）检测是一种可检测细胞角蛋白8和18尿碎片的标志物。本研究的目的是评估术前和术后UBC检测在经尿道膀胱肿瘤切除术后第一年检测膀胱肿瘤早期复发的有效性。
对36例接受经尿道切除术（TUR）治疗的浅表性膀胱癌（pTa-pT1）患者进行了多中心前瞻性研究。每位患者进行4次特定的尿液采集：1）术前，2）TUR后3天，3）TUR后7天，4）TUR后30天。采用免疫放射分析法（IRMA）对尿液中的UBC进行分析，使用的临界值为12mg/L。TUR后3、6、9和12个月进行膀胱镜检查，目的是识别术后第一年的所有癌症复发情况。根据Fisher精确检验和卡方分析进行统计分析，以确定有或无早期复发患者之间的差异。
在纳入研究的36例患者中，15例出现早期复发，21例术后1年无复发。TUR后30天无复发患者的UBC水平显示正常，与术前水平相比有所下降，或在两种情况下均下降，即使两组之间未发现统计学上的显著差异。
在本研究中，我们报告了UBC水平的术后变化与随访第一年肿瘤复发风险之间无显著相关性。一个更大的研究组和更长的随访时间可能会更好地评估UBC检测在临床实践中的实际效力。
