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

摘要： 目的 探讨术前尿BTA、NMP22定量联合测定对膀胱癌的诊断价值。方法 选取2021年1月至2022年09月于惠州市中心人民医院泌尿外科确诊为膀胱癌的73例患者作为观察组,另选取同期就诊的73例泌尿系统良性疾病患者作为对照组。检测两组患者术前尿BTA、NMP22定量水平,根据检测结果回顾性分析两个指标在膀胱癌中的单项及联合诊断价值,同时分析不同临床肿瘤特征患者上述两个指标的阳性率差异情况。结果 观察组和对照组的术前尿BTA定量水平分别为（997.85±237.73）pg/mL、（691.33±190.16）pg/mL;NMP22定量水平分别为（8.57±1.49）ng/mL、（6.23±1.29）ng/mL。与对照组相比,观察组患者术前尿BTA、NMP22水平均明显升高（P<0.01）。术前尿BTA、NMP22在膀胱癌诊断中的灵敏度分别为76.7%和78.1%,特异度为90.4%和91.8%,曲线下面积分别为0.849和0.867,此时两者的最佳截断值分别为834.55 pg/mL和7.47 ng/mL。两者联合诊断的灵敏度、特异度、曲线下面积分别为89.0%、87.7%、0.931,其中灵敏度及曲线下面积均较单项检测高。不同年龄、性别、BMI、吸烟情况患者的BTA和NMP22阳性率比较,差异无统计学意义（P>0.05）;而不同肿瘤直径、肿瘤数目、肿瘤分级、肿瘤分期患者的BTA和NMP22阳性率比较,差异具有统计学意义（P<0.05）。结论 术前尿BTA、NMP22定量水平测定对膀胱癌具有较好的诊断效能,具备无创、便捷、可批量检测等优点,且两者联合检测可提高诊断敏感度,减少漏诊可能,值得用于临床实践。

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