本文選題：ELISA + BTA��； 參考：《廣西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的探討尿膀胱腫瘤抗原(BTA)的臨床應(yīng)用價(jià)值及血尿?qū)z測(cè)的影響。方法1.第一部分研究為三組,將46例膀胱癌、35例泌尿系良性疾病、10例健康者尿液納入研究,分別設(shè)為膀胱癌組、良性疾病組、健康對(duì)照組。各組樣本同時(shí)作尿脫落細(xì)胞學(xué)及BTA檢測(cè)。2.第二部分實(shí)驗(yàn)為兩組,分別為血尿模型組和膀胱癌組。設(shè)計(jì)血尿模型:將10個(gè)健康體檢者納入研究,留取各實(shí)驗(yàn)對(duì)象的尿液50ml及自體血液2ml,取各健康者0、1、5、50、100 ul血液樣品分別與10 ml自體尿液混勻,分別制成0,1/10000,1/2000,1/200,1/100各5種不同比例的血尿;膀胱癌組為50個(gè)膀胱癌患者新鮮晨尿;以光學(xué)顯微鏡觀察兩組樣本高倍鏡下血尿濃度,并應(yīng)用ELISA法測(cè)定各樣本中BTA含量。結(jié)果1.BTA檢測(cè)的AUC為0.863,95%可信區(qū)間為(0.759、0.924),尿細(xì)胞學(xué)的AUC為0.670,95%可信區(qū)間為(0.550、0.775),兩組AUC差別有統(tǒng)計(jì)學(xué)意義(P=0.000);2.膀胱癌組BTA水平與良性疾病組、健康組差別有統(tǒng)計(jì)學(xué)意義(P0.01);3.BTA表達(dá)水平和敏感性與腫瘤分級(jí)分期、有無(wú)肉眼血尿有關(guān)(P0.01),復(fù)發(fā)膀胱癌BTA表達(dá)水平與初發(fā)組差別無(wú)統(tǒng)計(jì)學(xué)意義(Z=-0.721,P=0.324);BTA對(duì)各級(jí)、各期的膀胱癌的靈敏度均高于尿細(xì)胞學(xué)(P0.01);3.BTA在早期膀胱癌(Ta-T1期)中表達(dá)水平與良性疾病組、健康組差別有統(tǒng)計(jì)學(xué)意義(P0.01);4.血尿模型組:血尿濃度與BTA含量成正相關(guān)(rs=0.98 P=0.00),BTA值隨血尿濃度升高而升高。膀胱癌組:紅細(xì)胞數(shù)≤50/hp時(shí),BTA中位值為67ng/ml,50/hp血尿濃度≤250/hp時(shí),BTA中位值為118ng/ml,組間差別有統(tǒng)計(jì)學(xué)意義(P0.000)。血尿程度相近時(shí)膀胱癌組BTA表達(dá)水平與血尿模型組差別有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論尿BTA檢測(cè)對(duì)膀胱癌的早期診斷和跟蹤隨訪有較高的臨床應(yīng)用價(jià)值,并且有助于膀胱癌的早期篩查。但應(yīng)注意濃血尿?qū)z測(cè)結(jié)果的放大作用。
[Abstract]:Objective to investigate the clinical value of urinary bladder tumor antigen (BTAA) and the effect of hematuria on detection.Method 1.The first part of the study was divided into three groups, including 46 cases of bladder cancer and 35 cases of urinary tract benign diseases and 10 cases of healthy people, which were divided into bladder cancer group, benign disease group and healthy control group.Urine exfoliative cytology and BTA detection were performed in all groups.The second part of the experiment was divided into two groups: hematuria model group and bladder cancer group.To design a hematuria model: ten healthy people were included in the study, the urine 50ml and autologous blood were collected from 10 healthy subjects. The blood samples of each healthy person were mixed with 10 ml autologous urine, and 5 different proportions of hematuria were made.50 patients with bladder cancer were treated with fresh morning urine. The concentration of hematuria in the two groups was observed under high power microscope and the content of BTA in each sample was determined by ELISA method.Results the AUC of 1.BTA was 0.863n 95% confidence interval was 0.759U 0.924, the AUC of urine cytology was 0.670v 95% confidence interval was 0.5500.7750.The difference of AUC between the two groups was statistically significant.The expression and sensitivity of BTA in bladder cancer group were significantly higher than those in benign disease group and healthy group.There was no significant difference between the BTA expression level of recurrent bladder cancer and that of primary bladder cancer. The sensitivity of BTA in all stages of bladder cancer was higher than that of urine cytology in early stage of bladder cancer (Ta-T1).The difference between the healthy group and the control group was statistically significant (P 0.01).In the hematuria model group, there was a positive correlation between serum urine concentration and BTA content.In bladder cancer group, the median value of BTA when erythrocyte number 鈮，

本文編號(hào)：1756959