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目的:探讨尿纤维连接蛋白(fibronectin,Fn)与上尿路移行细胞癌的生物学关系。方法:采用ELISA法检测30例上尿路移行细胞癌、25例其它泌尿系疾病患者及20例正常人尿液Fn含量,并同时测定尿肌酐(Creatin,Cr),计算Fn/Cr比值,比较各组人群尿Fn/Cr比值之间的差异;分析不同肿瘤分期、分级尿Fn/Cr之间的差异;比较其与尿脱落细胞学检测上尿路移行细胞癌的敏感性。结果:上尿路移行细胞癌尿Fn/Cr比值为(46.4±26.5)mg/mol,明显高于正常人(14.7±8.8)mg/mol及其它泌尿系疾病患者(28.2±22.7)mg/mol。以34mg/mol为标准,尿Fn/Cr比值诊断上尿路移行细胞癌的灵敏度和特异度分别为73.3%和77.8%。尿Fn/Cr比值与上尿路肿瘤分期分级有关。尿脱落细胞学检测上尿路移行细胞癌的敏感性为53.3%,采用Fn/Cr检测较脱落细胞学检查敏感性无统计学意义(P>0.05)。结论:尿Fn/Cr可作为上尿路移行细胞癌的诊断指标。其高低与膀胱癌的分期、分级有关,可大致判断浸润度和恶性度,并可用于上尿路移行细胞癌的预后评估。
Objective: To investigate the biological relationship between urinary fibronectin (Fn) and transitional cell carcinoma of upper urinary tract. Methods: The urinary Fn levels in 30 cases of upper urinary tract transitional cell carcinoma, 25 cases of other urological diseases and 20 cases of normal urine were detected by ELISA. The levels of creatinine (Cr) were also measured and the ratio of Fn / Cr was calculated. The difference of Fn / Cr ratio of urine in each group was analyzed. The difference of Fn / Cr in different stage and grade of urine was analyzed. The sensitivity of urinary exfoliative cytology in detection of upper urinary tract transitional cell carcinoma was compared. Results: The urinary Fn / Cr ratio of upper urinary tract transitional cell carcinoma was (46.4 ± 26.5) mg / mol, significantly higher than that of normal (14.7 ± 8.8) mg / mol and other urological diseases (28.2 ± 22.7) mg / mol . With 34 mg / mol as the standard, the sensitivity and specificity of urinary Fn / Cr ratio in diagnosing upper urinary tract transitional cell carcinoma were 73.3% and 77.8%, respectively. Urine Fn / Cr ratio and upper urinary tract cancer staging related. Urinary exfoliative cytology detection of upper urinary tract transitional cell carcinoma sensitivity was 53.3%, using Fn / Cr detection than exfoliated cytology test sensitivity was not statistically significant (P> 0.05). Conclusion: Urine Fn / Cr can be used as a diagnostic indicator of upper urinary tract transitional cell carcinoma. The level of bladder cancer staging, grading, can be roughly determine the degree of invasion and malignancy, and can be used for the evaluation of the prognosis of upper urinary tract transitional cell carcinoma.