目的 探讨膀胱肿瘤抗原(BTA)的临床应用价值.方法 收集46例膀胱癌、35例泌尿系良性疾病、10例健康者尿液,同时做尿脱落细胞学及BTA检测.结果 ①BTA检测的敏感性为86.9%,特异性为82.2%,假阳性率为17.8%(95%CI:0.759,0.924);尿脱落细胞学检测的敏感性为34.7%,特异性为97.8%,假阳性率为2.2%(95%CI:0.550,0.775);②BTA表达水平和敏感性与肿瘤分级分期、有无肉眼血尿有关(P<0.05),与复发或初发无关(P>0.05);BTA对各级、各期的膀胱癌的敏感性均高于尿脱落细胞学检测(P<0.05);③BTA在早期膀胱癌(Ta~T1期)中表达水平高于良性疾病组、健康组(P<0.05).结论 BTA对膀胱癌的诊断、早期筛查及跟踪随访有较高的临床应用价值,但应注意血尿影响BTA检测结果.%Objective To assess the diagnostic value of bladder tumor antigen (BTA) in the detection of bladder cancer. Methods Subjects, including 46 patients with bladder cancer, 35 patients with urological benign diseases, and 10 normal individuals were enrolled in this study. All subjects received urine BTA assay and urinary cytology before cystoscopy. Cystoscopic result was the standard of detection. Results The sensitivity, specificity and false positive rate of the BTA test were 86.9%, 82.2% and 17.8% (95% CI: 0.759, 0.924) respectively; the sensitivity, specificity and false positive rate of cytological test were 34.7%, 97.8% and 2.2%(95% CI: 0.550, 0.775) respectively. The expression level of BTA and sensitivity were correlated to tumor stage, grade and hematuria degree (P<0.05), but not correlated to relapse or initial cancer (P>0.05). The sensitivity of BTA in diagnosis of bladder cancer at all grades and stages was higher than that of urinary cytology (P<0.05). The level of BTA in the non-invasive bladder cancer group was significantly higher than that in the healthy group and the benign disease group (P<0.05). Conclusions Urinary BTA expression has a high clinical value in the diagnosis, early screening and follow-up of bladder cancer, but attention should be paid to the effect of hematuria on BTA test results.
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