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目的:探讨尿液载脂蛋白-A1(Apo-A1)在膀胱癌诊断中的临床价值。方法:收集膀胱癌患者及健康人尿液标本行双向电泳,根据电泳图谱挑选表达差异显著的蛋白进行质谱鉴定分析;免疫印迹验证后ELISA方法检测尿液中差异蛋白的表达水平,绘制受试者工作特征(ROC)曲线以确定该蛋白对膀胱癌诊断的最佳工作点,并进行大样本临床验证试验,计算相应的特异度和灵敏度;并分析差异蛋白检测与尿脱落细胞检查联合应用诊断膀胱癌的临床价值。结果:尿液双向电泳结合质谱分析结果显示,Apo-A1在膀胱癌组呈现显著的高表达趋势。ELISA结果表明Apo-A1在膀胱癌组含量明显高于健康对照组,差异有统计学意义(P<0.01);以19.21μg/L为临界点,可将膀胱癌患者与非膀胱癌患者较好区分,灵敏度为88.3%,特异度为83.7%。将Apo-A1检测与尿脱落细胞学检查联合应用,能够明显提高膀胱癌诊断的灵敏度。结论:Apo-A1有可能是膀胱癌诊断的一个生物学标志物,具有潜在的临床应用价值。
Objective: To investigate the clinical value of urinary apolipoprotein-A1 (Apo-A1) in the diagnosis of bladder cancer. Methods: Urine specimens from patients with bladder cancer and healthy people were collected for two-dimensional electrophoresis. Proteins with significant differences were selected according to the electrophoretogram and analyzed by mass spectrometry. Western blotting was used to detect the expression of differential proteins in urine by ELISA. (ROC) curve to determine the best working point for the diagnosis of bladder cancer, and a large sample of clinical validation test to calculate the corresponding specificity and sensitivity; and differential protein detection and urinary cytology combined with the diagnosis of the bladder The clinical value of cancer. Results: Urine two-dimensional electrophoresis combined with mass spectrometry results showed that Apo-A1 in bladder cancer group showed a significant trend of high expression. ELISA results showed that Apo-A1 in bladder cancer group was significantly higher than the healthy control group, the difference was statistically significant (P <0.01); 19.21μg / L as the critical point, bladder cancer patients with non-bladder cancer patients better The sensitivity was 88.3% and the specificity was 83.7%. Apo-A1 test combined with urinary cytology can significantly improve the sensitivity of bladder cancer diagnosis. Conclusion: Apo-A1 may be a biomarker for the diagnosis of bladder cancer, which has potential clinical value.