Department of Urology and Shenzhen Key Laboratory of Male Reproduction and Genetics, Peking University Shenzhen Hospital, PR China.
Urology. 2010 Aug;76(2):514.e6-11. doi: 10.1016/j.urology.2009.11.045. Epub 2010 Mar 25.
Current methods for reliable detection of bladder cancer have some limitations. Finding better noninvasive methods for detection of bladder cancer is an important topic in urology. We want to evaluate prospectively the early detection power of human uroplakin 3 A (UPK3A) for bladder cancer.
Urine samples were obtained from 32 healthy volunteers, 44 patients with benign urological disorders and 122 patients with bladder cancer. The urine UPK3A levels were quantified by enzyme-linked immunosorbent assay. All the samples were also tested with NMP22 test and cytology examination.
The urinary UPK3A levels are uniformly elevated in bladder cancer patients than in those of normal volunteers and patients with benign urological disorders, and the differences in the mean urinary UPK3A levels of bladder cancer patients and those of normal individuals or benign urological disorders are statistically significant (P <.01). The receiver operating characteristic (ROC) curve of UPK3A showed an excellent area under the ROC curve of 0.907. In this study, the optimal combination of sensitivity and specificity were determined as 83% and 83%, for a cut-off value of absorbance unit 0.0685, respectively. The sensitivity of urine UPK3A, NMP22, and cytology for detecting bladder cancer were 83%, 58%, and 64%, respectively, whereas specificity was 83%, 75%, and 82%, respectively.
We conclude that individuals with bladder cancer have higher UPK3A values. Our data suggest that urine measurement of UPK3A is a sensitive marker for the detection of bladder cancer. However, it needs further studies in larger cohorts.
目前可靠检测膀胱癌的方法存在一些局限性。寻找更好的非侵入性膀胱癌检测方法是泌尿科的一个重要课题。我们旨在前瞻性评估人尿路上皮多角蛋白 3A（UPK3A）对膀胱癌的早期检测能力。
收集 32 名健康志愿者、44 名良性泌尿科疾病患者和 122 名膀胱癌患者的尿液样本。采用酶联免疫吸附试验定量检测尿液 UPK3A 水平。所有样本均同时进行 NMP22 试验和细胞学检查。
膀胱癌患者的尿 UPK3A 水平普遍高于健康志愿者和良性泌尿科疾病患者，膀胱癌患者和健康个体或良性泌尿科疾病患者的尿 UPK3A 水平均值差异具有统计学意义（P <.01）。UPK3A 的受试者工作特征（ROC）曲线显示出优异的 ROC 曲线下面积为 0.907。在本研究中，确定了灵敏度和特异性的最佳组合，截断值为吸光度单位 0.0685 时，灵敏度为 83%，特异性为 83%。尿 UPK3A、NMP22 和细胞学检测膀胱癌的灵敏度分别为 83%、58%和 64%，特异性分别为 83%、75%和 82%。
我们得出结论，膀胱癌患者的 UPK3A 值较高。我们的数据表明，尿液 UPK3A 测量是膀胱癌检测的敏感标志物。然而，它需要在更大的队列中进行进一步研究。
