关键词: 膀胱癌, 尿液无创诊断, 尿膀胱肿瘤抗原, 核基质蛋白22

Abstract: Objective To explore the diagnostic value of combined determination of bladder tumor of antigen（BTA）and nuclear matrix protein 22（NMP22）in urine before operation for bladder cancer. Methods Seventy-three patients with bladder cancer diagnosed in the Department of Urology of Huizhou Central People′s Hospital from January 2021 to September 2022 were selected as the observation group, and 73 patients with benign urinary diseases in the same period were selected as the control group. The quantitative levels of BTA and NMP22 in urine of the two groups were detected before operation. According to the detection results, the single and combined diagnostic value of the two indexes in bladder cancer were retrospectively analyzed, and the positive rates of the two indexes in patients with different clinical tumor conditions were analyzed. Results The preoperative urinary BTA quantitative levels in the observation group and the control group were （997.85±237.73） pg/ml and （691.33±190.16） pg/ml ;NMP22 expression levels were（8.57±1.49）ng/ml and （6.23±1.29） ng/ml, respectively. Compared with the control group, the levels of urinary BTA and NMP22 in the observation group were significantly higher than those in the control group （P<0.01）. The sensitivities of preoperative urine BTA and NMP22 in the diagnosis of bladder cancer were 76.7% and 78.1% respectively, the specificity were 90.4% and 91.8%, and the areas under the curve（AUC） were 0.849 and 0.867 respectively. At this time, the best cut-off values of 834.55 pg/ml and 7.47 ng/ml were respectively. The sensitivity, specificities and AUC of the combined diagnosis were 89.0%, 87.7% and 0.931 respectively, and the sensitivity and AUC were higher than those of single detection. There were no significant differences in the positive rates of BTA and NMP22 among patients with different age, sex, BMI and smoking（P>0.05）, but there was significant difference in the positive rates of BTA and NMP22 among patients with different tumor diameter, tumor number, tumor grade and tumor stage（P<0.05）. Conclusion The quantitative determination of urinary BTA and NMP22 before operation has a good diagnostic efficacy for bladder cancer, and it has the advantages of non-invasive, convenient and batch detection, and the combined detection of the two can improve the sensitivity of diagnosis and reduce the possibility of missed diagnosis, so it is worthy to be used in clinical practice.

Key words: bladder cancer, urine non-invasive diagnosis, urinary bladder tumor antigen, nuclear matrix protein 22