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J Urol:一种检测膀胱癌的灵敏度比尿细胞学更高的90分钟一体化尿液分析方法。

2017-10-30 fengxiangxin MedSci原创

尽管敏感性不佳,但尿细胞学通常作为膀胱镜检查诊断膀胱癌的辅助手段。本研究的目标是开发一种非侵入性,快速检测膀胱癌的分子诊断测试,它比尿细胞学检测的灵敏度更高,同时又能够保持足够的特异性。

尽管敏感性不佳,但尿细胞学通常作为膀胱镜检查诊断膀胱癌的辅助手段。本研究的目标是开发一种非侵入性,快速检测膀胱癌的分子诊断测试,它比尿细胞学检测的灵敏度更高,同时又能够保持足够的特异性。

本研究尿液标分别本来自18个分布在多个国家的医疗中心的患者(收集标本时他们还未接受膀胱镜检查或肿瘤切除术),以及没有膀胱癌证据的健康和其他对照受试者。研究者在训练队列(n = 483)中测量了10个尿mRNA的水平,并使用回归分析建立了5个mRNA模型以预测癌症状态。本研究使用仅用于膀胱癌分析的GeneXpert(Cepheid,Sunnyvale,CA),用于评估在独立的测试队列( N = 450)中五种mRNA(ABL1,CRH,IGF2,ANXA10和UPK1B)的情况。

在独立试验队列中,GeneXpert测定的ROC曲线AUC为0.87(95%CI:0.81-0.92)。在实例切点为0.4的地方,总体灵敏度为73%,血尿和监测患者人群的特异度分别为90%和77%。

因此,这个90分钟的,简单的通过尿液检测膀胱癌的检测方法,可以帮助医师在膀胱癌的管理中做出指导决策。需要进一步在前瞻性研究中进行额外的评估,以确定该方法的临床效用。

原始出处:

Wallace E, Higuchi R.Development of a 90-minute integrated non-invasive urinary assay for bladder cancer detection.J Urol. 2017 Oct 20. pii: S0022-5347(17)77760-9. doi: 10.1016/j.juro.2017.09.141.

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