尿核基质蛋白22和非典型细胞参数在膀胱癌诊断中的临床价值

doi:10.3969/j.issn.1673-8640.2023.08.006

摘要/Abstract

摘要：

目的探讨尿核基质蛋白22（NMP22）和尿有形成分分析仪非典型细胞（Atyp.C）参数联合检测诊断膀胱癌的价值。方法选取2021年10月—2022年9月上海市静安区市北医院行NMP22检测和尿有形成分分析的患者3 288例，其中膀胱癌患者97例（膀胱癌组，均为男性）、其他泌尿系统疾病患者3 191例[总对照组，其中男1 212例、女1 979例]；将1 212例男性泌尿系统疾病患者作为男性对照组。采用受试者工作特征（ROC）曲线评价各项指标诊断膀胱癌的效能。结果膀胱癌组NMP22阳性率和Atyp.C荧光强度显著高于男性对照组和总对照组（P<0.001）。ROC曲线分析结果显示，以男性对照组为参考，NMP22、Atyp.C荧光强度单项检测和联合检测诊断膀胱癌的曲线下面积（AUC）分别为0.794、0.757、0.867。以总对照组为参考，NMP22、Atyp.C荧光强度单项检测和联合检测诊断膀胱癌的AUC分别为0.787、0.752、0.861。结论在膀胱癌的诊断中，NMP22具有较高的敏感性，Atyp.C参数具有较高的特异性，联合检测可显著提高诊断效能。

关键词: 尿核基质蛋白22, 非典型细胞, 尿有形成分分析仪, 膀胱癌

Abstract:

Objective To investigate the clinical role of the combined determination of nuclear matrix protein 22（NMP22） and atypical cells（Atyp.C） parameter using urinary sediment analyzer in the diagnosis of bladder cancer. Methods Totally，3 288 patients with NMP22 and urinary sediment determinations in Jing'an District Shibei Hospital were enrolled from October 2021 to September 2022. There were 97 patients with bladder cancer（bladder cancer group，97 males） and 3 191 patients with other urinary system diseases（total control group，1 212 males and 1 979 females）. A total of 1 212 male patients with urinary system diseases were used as male control group. Receiver operating characteristic（ROC） curve was used to evaluate the efficiency of each index in the diagnosis of bladder cancer. Results The positive rate of NMP22 and the fluorescence intensity of Atyp.C in bladder cancer group were higher than those in male control group and total control group（P<0.001）. ROC curve analysis results showed that the areas under curves（AUC） of NMP22 and Atyp.C fluorescence intensity single and combined determinations in the diagnosis of bladder cancer were 0.794，0.757 and 0.867，respectively，when the male control group was taken as control group. When the total control group was used as control group，the AUC of NMP22 and Atyp.C fluorescence intensity single and combined determinations were 0.787，0.752 and 0.861，respectively. Conclusions In the diagnosis of bladder cancer，NMP22 has a high sensitivity，Atyp.C has a high specificity，and the combined determination can improve the diagnostic efficiency.

Key words: Nuclear matrix protein 22, Atypical cell, Urinary sediment analyzer, Bladder cancer

中图分类号:

R446.1

王月妹, 李磊. 尿核基质蛋白22和非典型细胞参数在膀胱癌诊断中的临床价值[J]. 检验医学, 2023, 38(8): 738-741.

WANG Yuemei, LI Lei. Clinical roles of nuclear matrix protein 22 and Atyp.C parameter in diagnosis of bladder cancer[J]. Laboratory Medicine, 2023, 38(8): 738-741.

图/表 5

参考文献 14

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组别	例数	年龄/岁	NMP22阳性/[例（%）]	Atyp.C荧光强度
膀胱癌组	97	60.0（62.0~68.0）^*#	73（75.3）^*#	1.30（0~3.15）^*#
男性对照组	1 212	66.0（47.0~70.0）	199（16.4）	0
总对照组	3 191	65.0（55.0~71.0）	567（17.8）	0

组别	例数	年龄/岁	NMP22阳性/[例（%）]	Atyp.C荧光强度
膀胱癌组	97	60.0（62.0~68.0）^*#	73（75.3）^*#	1.30（0~3.15）^*#
男性对照组	1 212	66.0（47.0~70.0）	199（16.4）	0
总对照组	3 191	65.0（55.0~71.0）	567（17.8）	0

TNM分期	例数	NMP22阳性/ [例（%）]	Atyp.C荧光强度
Ⅰ期	42	24（57.1）	0.00（0.00~1.25）
Ⅱ期	30	25（83.3）	2.25（0.00~3.98）
Ⅲ期	25	24（96.1）	2.90（1.75~4.90）
统计值		14.23	26.48
P值		0.001	<0.001

TNM分期	例数	NMP22阳性/ [例（%）]	Atyp.C荧光强度
Ⅰ期	42	24（57.1）	0.00（0.00~1.25）
Ⅱ期	30	25（83.3）	2.25（0.00~3.98）
Ⅲ期	25	24（96.1）	2.90（1.75~4.90）
统计值		14.23	26.48
P值		0.001	<0.001

项目	AUC（95%CI^①）	最佳临界值	敏感性	特异性	Youden指数
NMP22	0.794（0.743~0.845）	1^②	75.3	83.6	0.589
Atyp.C荧光强度	0.757（0.692~0.821）	0.59	55.7	97.6	0.533
联合检测	0.867（0.821~0.913）	0.884 9	85.6	81.5	0.671