ATYP.C在膀胱癌辅助诊断中的价值及其与MTHFR基因型的相关性

doi:10.3969/j.issn.1673-8640.2026.05.006

摘要/Abstract

摘要：

目的探讨尿液分析中非典型细胞（ATYP.C）和血液相关炎症指标在膀胱癌辅助诊断和MTHFR基因分型中的价值。方法选取复旦大学附属肿瘤医院膀胱癌患者207例（膀胱癌组）、非肿瘤体检者56名（对照组）。收集所有研究对象的临床资料，并检测血常规、尿素、肌酐（Cr）、尿酸（UA）、MTHFR基因型和ATYP.C，计算中性粒细胞/淋巴细胞比值（NLR）、单核细胞/淋巴细胞比值（MLR）、血小板/淋巴细胞比值（PLR）。采用Logistic回归分析（向前：LR）评估膀胱癌发生的影响因素。采用受试者工作特征（ROC）曲线评价ATYP.C诊断膀胱癌的效能。结果膀胱癌组尿路感染所占比例、尿素、NLR、MLR、PLR、ATYP.C均显著高于对照组（P<0.05），尿酸（UA）、白细胞（WBC）计数、中间细胞绝对数（MID#）、嗜碱性粒细胞绝对数（BASO#）和淋巴细胞绝对数（LYMPH#）均低于对照组（P<0.05）。Cr、血小板（PLT）计数、中性粒细胞绝对数（NEUT#）和嗜酸性粒细胞绝对数（EO#）差异均无统计学意义（P>0.05）。ATYP.C异常、PLR异常是膀胱癌发生的独立危险因素（P<0.01）。ATYP.C、PLR、NLR、MLR诊断膀胱癌的曲线下面积（AUC）分别为0.898、0.734、0.753、0.647。无论有无尿路感染，ATYP.C均是膀胱癌发生的独立危险因素（P<0.05）。TT基因型膀胱癌患者ATYP.C异常率（93.62%）显著高于CC基因型患者（76.19%）和CT基因型患者（83.33%）（P=0.016）。结论 ATYP.C与膀胱癌发生和MTHFR基因C677T位点多态性有关，或可作为膀胱癌辅助诊断的指标之一。

关键词: 非典型细胞, 血小板/淋巴细胞比值, MTHFR基因, 尿液, 膀胱癌

Abstract:

Objective To investigate the role of atypical cells（ATYP. C）in urine analysis and blood-related inflammatory indicators in the auxiliary diagnosis of bladder cancer and MTHFR gene typing. Methods Totally，207 patients with bladder cancer（bladder cancer group）and 56 non-tumor subjects（control group）were enrolled from Shanghai Cancer Center of Fudan University. The clinical data were collected，and blood routine test，urea，creatinine（Cr），uric acid（UA），MTHFR genotype and ATYP. C were performed and determined. The neutrophil-to-lymphocyte ratio（NLR），monocyte-to-lymphocyte ratio（MLR），platelet-to-lymphocyte ratio（PLR）were calculated. Logistic regression analysis（forward：LR）was used to evaluate the influencing factors of bladder cancer occurrence. Receiver operating characteristic（ROC）curve was used to evaluate the efficacy of ATYP. C in diagnosing bladder cancer. Results The proportion of urinary tract infection，urea，NLR，MLR，PLR and ATYP. C in bladder cancer group were higher than those in control group（P<0.05），while UA，white blood cell（WBC）count，the absolute value of mid-sized cells（MID#），the absolute value of basophils（BASO#） and the absolute value of lymphocytes（LYMPH#） were lower than those in control group（P<0.05）. There was no statistical significance in Cr，platelet（PLT）count，the absolute value of neutrophils（NEUT#）and the absolute value of eosinophils（EO#）（P>0.05）. ATYP. C and PLR abnormalities were independent risk factors for bladder cancer occurrence（P<0.01）. The areas under curves（AUC）of ATYP. C，PLR，NLR and MLR for diagnosing bladder cancer were 0.898，0.734，0.753 and 0.647，respectively. Regardless of the presence or absence of urinary tract infection，ATYP. C was an independent risk factor for bladder cancer occurrence（P<0.05）. The abnormal rate of ATYP. C in patients with TT genotype（93.62%）was higher than those in patients with CC genotype（76.19%） and CT genotype（83.33%）（P=0.016）. Conclusions ATYP. C is related to the occurrence of bladder cancer and the MTHFR gene C677T polymorphism，and it may be one of the indicators for the auxiliary diagnosis of bladder cancer.

Key words: Atypical cell, Platelet-to-lymphocyte ratio, MTHFR gene, Urine, Bladder cancer

中图分类号:

R446.12

杨琳, 卢仁泉, 郭林, 仲瑷玲. ATYP.C在膀胱癌辅助诊断中的价值及其与MTHFR基因型的相关性[J]. 检验医学, 2026, 41(5): 452-458.

YANG Lin, LU Renquan, GUO Lin, ZHONG Ailing. Role of ATYP. C in the auxiliary diagnosis of bladder cancer and its correlation with MTHFR gene typing[J]. Laboratory Medicine, 2026, 41(5): 452-458.

图/表 7

参考文献 28

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项目	AUC（95%CI①）	最佳临界值	敏感性/%	特异性/%	Youden指数
NLR	0.753（0.684~0.821）	2.081	58.90	82.10	0.410
MLR	0.647（0.574~0.720）	0.255	46.90	82.10	0.290
PLR	0.734（0.668~0.800）	124.438	60.40	78.60	0.390
ATYP.C	0.898（0.848~0.949）	0.550 个·μL^-1	83.10	91.10	0.742

项目	AUC（95%CI①）	最佳临界值	敏感性/%	特异性/%	Youden指数
NLR	0.753（0.684~0.821）	2.081	58.90	82.10	0.410
MLR	0.647（0.574~0.720）	0.255	46.90	82.10	0.290
PLR	0.734（0.668~0.800）	124.438	60.40	78.60	0.390
ATYP.C	0.898（0.848~0.949）	0.550 个·μL^-1	83.10	91.10	0.742

因素	赋值	β值	标准误	Wald值	P值	OR值（95%CI）
ATYP.C	正常（≤0.550 个·μL^-1）=0，异常（>0.550 个·μL^-1）=1	3.91	0.5	7.77	<0.001	50.13（18.67~134.60）
PLR	正常（≤124.438）=0，异常（>124.438）=1	1.64	0.34	4.82	<0.001	5.17（2.65~10.08）
NLR	正常（≤2.081）=0，异常（>2.081）=1	1.89	0.38	5.01	<0.001	6.60（3.16~13.81）
MLR	正常（≤0.255）=0，异常（>0.255）=1	1.40	0.38	3.73	<0.001	4.06（1.94~8.47）
LYMPH#	正常[（1.1~3.2）×10⁹L^-1]=0，异常（<1.1×10⁹L^-1或>3.2×10⁹L^-1）=1	1.58	0.75	2.12	0.034	4.85（1.12~20.89）
BASO#	正常（≤0.06×10⁹L^-1）=0，异常（>0.06×10⁹L^-1）=1	-1.58	0.63	-2.52	0.012	0.21（0.06~0.70）
尿素	正常（3.6 mmol·L^-1~9.5 mmol·L^-1）=0，异常（<3.6 mmol·L^-1或>9.5 mmol·L^-1）=1	0.21	0.57	0.37	0.710	1.24（0.40~3.82）
UA	正常（208 mmol·L^-1~428μmol·L^-1）=0，异常（<208μmol·L^-1或>428μmol·L^-1）=1	-0.36	0.38	-0.96	0.335	0.70（0.33~1.46）
WBC计数	正常（3.5×10⁹L^-1~9.5×10⁹L^-1）=0，异常（<3.5×10⁹L^-1或>9.5×10⁹L^-1）=1	-0.11	0.68	-0.16	0.872	0.90（0.24~3.38）
MID#	正常（0.1×10⁹L^-1~0.6×10⁹L^-1）=0，异常（<0.1×10⁹L^-1或>0.6×10⁹L^-1）=1	-0.53	0.48	-1.11	0.267	0.59（0.23~1.50）

因素	赋值	β值	标准误	Wald值	P值	OR值（95%CI）
ATYP.C	正常（≤0.550 个·μL^-1）=0，异常（>0.550 个·μL^-1）=1	3.91	0.5	7.77	<0.001	50.13（18.67~134.60）
PLR	正常（≤124.438）=0，异常（>124.438）=1	1.64	0.34	4.82	<0.001	5.17（2.65~10.08）
NLR	正常（≤2.081）=0，异常（>2.081）=1	1.89	0.38	5.01	<0.001	6.60（3.16~13.81）
MLR	正常（≤0.255）=0，异常（>0.255）=1	1.40	0.38	3.73	<0.001	4.06（1.94~8.47）
LYMPH#	正常[（1.1~3.2）×10⁹L^-1]=0，异常（<1.1×10⁹L^-1或>3.2×10⁹L^-1）=1	1.58	0.75	2.12	0.034	4.85（1.12~20.89）
BASO#	正常（≤0.06×10⁹L^-1）=0，异常（>0.06×10⁹L^-1）=1	-1.58	0.63	-2.52	0.012	0.21（0.06~0.70）
尿素	正常（3.6 mmol·L^-1~9.5 mmol·L^-1）=0，异常（<3.6 mmol·L^-1或>9.5 mmol·L^-1）=1	0.21	0.57	0.37	0.710	1.24（0.40~3.82）
UA	正常（208 mmol·L^-1~428μmol·L^-1）=0，异常（<208μmol·L^-1或>428μmol·L^-1）=1	-0.36	0.38	-0.96	0.335	0.70（0.33~1.46）
WBC计数	正常（3.5×10⁹L^-1~9.5×10⁹L^-1）=0，异常（<3.5×10⁹L^-1或>9.5×10⁹L^-1）=1	-0.11	0.68	-0.16	0.872	0.90（0.24~3.38）
MID#	正常（0.1×10⁹L^-1~0.6×10⁹L^-1）=0，异常（<0.1×10⁹L^-1或>0.6×10⁹L^-1）=1	-0.53	0.48	-1.11	0.267	0.59（0.23~1.50）

因素	β值	标准误	Wald值	P值	OR值（95%CI）
ATYP.C	3.78	0.54	7.04	<0.001	43.67（15.25~125.03）
NLR	0.53	0.59	0.90	0.367	1.71（0.54~5.44）
MLR	0.31	0.59	0.53	0.593	1.37（0.43~4.31）
PLR	1.40	0.49	2.86	0.004	4.04（1.55~10.49）
BASO#	-0.94	1.05	-0.90	0.371	0.39（0.05~3.05）
LYMPH#	-0.03	1.09	-0.03	0.978	0.97（0.11~8.23）