Sun Yi, He Da-lin, Ma Qiang, Wan Xing-yang, Zhu Guo-dong, Li Lei, Luo Yong, He Hui, Yang Lin
Institute of Urology, First Affiliated Hospital of Medical School, Xi'an Jiaotong University, Xi'an 710061, China.
Chin Med J (Engl). 2006 Nov 5;119(21):1763-71.
We compared the validity (evaluated by sensitivity and specificity), reliability (evaluated by reproducibility) and yield (evaluated by predictive value, examining complexity and cost) of individual and combined tests for bladder tumour antigen stat (BTAstat), nuclear matrix protein 22 (NMP22), hyaluronic acid (HA), survivin, CD44v6, vascular endothelial growth factor (VEGF), and voided urine cytology (VUC) in detecting bladder cancer. And at the same time we evaluated the clinical value of these seven detecting methods in the diagnosis of bladder cancer.
The six markers and VUC were detected in the urine of cancer group (151 patients with bladder cancer) and two control groups (50 patients with benign urological diseases and 50 healthy controls). The sensitivity, specificity, predictive value, reproducibility, examining complexity and checking cost of each marker and combined markers were calculated.
There was a significant difference between bladder cancer group and the two control groups. The sensitivity, specificity and positive predictive value were as follows: VUC (36.4%, 100.0%, 100%), BTAstat (76.8%, 87.0%, 89.9%), NMP22 (77.5%, 81.0%, 86.0%), HA (82.8%, 83.0%, 88.0%), survivin (70.2%, 85.0%, 87.6%), CD44v6 (50.3%, 79.0%, 78.4%), and VEGF (68.2%, 93.0%, 93.6%). The highest sensitivities were 91.4% for NMP22 + BTAstat and HA + NMP22, whereas the combined marker with the lowest sensitivity (62.3%) was VUC + CD44v6. The highest specificity was 93.0% for the combined use of VUC + VEGF and HA + CD44v6 had the lowest specificity (73.0%). The most convenient examining method was the detection for BTAstat, the lowest cost was the detection for HA, and the best reproducibility were the detection for BTAstat and VUC.
All the markers have obvious clinical value in diagnosis of bladder cancer. The use of BTAstat + HA or NMP22 + BTAstat are better examining methods in terms of validity, reliability, and yield.
我们比较了单独检测和联合检测膀胱肿瘤抗原速测法（BTAstat）、核基质蛋白22（NMP22）、透明质酸（HA）、生存素、CD44v6、血管内皮生长因子（VEGF）以及尿脱落细胞学检查（VUC）在检测膀胱癌时的有效性（通过敏感性和特异性评估）、可靠性（通过可重复性评估）和检出率（通过预测值、检查复杂性和成本评估）。同时，我们评估了这七种检测方法在膀胱癌诊断中的临床价值。
在癌症组（151例膀胱癌患者）和两个对照组（50例良性泌尿系统疾病患者和50例健康对照者）的尿液中检测六种标志物及VUC。计算每种标志物及联合标志物的敏感性、特异性、预测值、可重复性、检查复杂性和检查成本。
膀胱癌组与两个对照组之间存在显著差异。敏感性、特异性和阳性预测值如下：VUC（36.4%，100.0%，100%），BTAstat（76.8%，87.0%，89.9%），NMP22（77.5%，81.0%，86.0%），HA（82.8%，83.0%，88.0%），生存素（70.2%，85.0%，87.6%），CD44v6（50.3%，79.0%，78.4%），VEGF（68.2%，93.0%，93.6%）。NMP22+BTAstat和HA+NMP22的敏感性最高，为91.4%，而敏感性最低的联合标志物是VUC+CD44v6（62.3%）。VUC+VEGF联合使用时特异性最高，为93.0%，HA+CD44v6的特异性最低（73.0%）。最便捷的检查方法是检测BTAstat，成本最低的是检测HA，可重复性最好的是检测BTAstat和VUC。
所有标志物在膀胱癌诊断中均具有明显的临床价值。就有效性、可靠性和检出率而言，使用BTAstat+HA或NMP22+BTAstat是更好的检查方法。
