Feng C C, Wang P H, Guan M, Jiang H W, Wen H, Ding Q, Wu Z
Department of Urology, Huashan Hospital, Fudan University, Shanghai, PR China.
Folia Biol (Praha). 2011;57(6):242-7.
BLCA-4 is currently the most sensitive and specific urinary marker for bladder cancer. As the incidence of bladder cancer varies by ethnic and territory, we tended to evaluate the feasibility of bladder cancer detection using urinary BLCA-4 in Chinese Han nationality. Urines from 79 bladder cancer patients, 31 urinary tract infection patients and 29 normal controls were included. Tissue specimens of 53 bladder cancers, 24 pathologically normal tumour- adjacent urothelium and 15 healthy controls were involved. BLCA-4 antibody was produced and applied in an indirect ELISA assay for urine samples and immunohistochemistry study in tissue samples. Urinary BLCA-4 was significantly higher in the bladder cancer group (P=0.0001). The level was in no relation to age, gender, growth pattern, grade or stage. Discrepant to reported data, a cut-off value of 1.7×10⁻⁴ A was acquired here, which yields a sensitivity of 97.37% and specificity of 100%. Muscle invasiveness was related to a higher BLCA-4 level (P=0.0175). Tumour tissues were also scored higher in staining (P=0.0001), yet this was not related to invasiveness. In 41.67% of adjacent normal tissue we found positive BLCA-4 expression. Urinary BLCA-4 was also highly specific in bladder cancer detection in the Chinese, with additional indicative value in muscle invasiveness detection. A cut-off value of 1.7×10⁻⁴ A may be more adaptive to Chinese Han population.
BLCA-4是目前膀胱癌最敏感且特异的尿液标志物。由于膀胱癌的发病率因种族和地域而异，我们倾向于评估在中国汉族人群中使用尿液BLCA-4检测膀胱癌的可行性。研究纳入了79例膀胱癌患者、31例尿路感染患者及29例正常对照者的尿液。还涉及53例膀胱癌、24例病理正常的肿瘤旁尿路上皮组织标本及15例健康对照的组织标本。制备了BLCA-4抗体，并将其应用于尿液样本的间接ELISA检测及组织样本的免疫组化研究。膀胱癌组尿液BLCA-4水平显著更高（P = 0.0001）。该水平与年龄、性别、生长模式、分级或分期无关。与已报道的数据不同，本研究获得的临界值为1.7×10⁻⁴ A，其灵敏度为97.37%，特异性为100%。肌层浸润性与较高的BLCA-4水平相关（P = 0.0175）。肿瘤组织的染色评分也更高（P = 0.0001），但这与浸润性无关。在41.67%的肿瘤旁正常组织中发现了BLCA-4阳性表达。尿液BLCA-4在中国人群膀胱癌检测中也具有高度特异性，在肌层浸润性检测方面具有额外的指示价值。临界值1.7×10⁻⁴ A可能更适用于中国汉族人群。
