The Value Of Combined Detection Of Urinary Protein In Clinical Diagnosis Of Urothelial Carcinoma

Background: Urothelial carcinoma(UC)mainly includes two types: bladder cancer(BC)and upper tract urothelial carcinoma(UTUC).Recent high-throughput sequencing has identified urothelial carcinoma as one of the most genetically complex tumors with clinical manifestations prone to recurrence,invasion,and metastasis.In addition,it is difficult to diagnose and follow up surveillance for early BC and UTUC.The main diagnostic method for the diagnosis of BC and UTUC is endoscopy,which is invasive and causes patient discomfort,and is costly,demanding,and subjectively biased for diagnosis.Therefore,there is an urgent need to explore tumor markers with good diagnostic and follow-up significance in urothelial cancer and to explore the existence of better tumor markers in urothelial cancer,which is always the focus of academic research.Objective: In this study,we selected the protein tumor markers BTA,NMP22,MMP9 and SURVIVIN of bladder and upper urinary tract urothelial carcinoma for combined detection,and remembered their clinical diagnostic value.Using magnetic particle chemiluminescence to detect the expression of four protein markers in urine and construct a clinical diagnostic strategy for protein detection alone or in combination,to explore its value as a new generation of clinical testing tools and to achieve greater clinical benefit for patients.Methods : A total of 170 midstream urine samples were collected from patients with bladder cancer(53 cases),upper tract urothelial carcinoma(35 cases),healthy controls(50cases)and non-tumor interfering disease(32 cases).The protein expression of clinical urine samples was recorded and statistically analyzed after correction.The ROC and AUC of clinical diagnostic strategies for different combinations of protein markers are calculated by the logistic binary regression equation to compare the sensitivity and specificity of each diagnostic strategy.Conclusions: BTA performed best in UC with AUC of 0.871(p < 0.05)and sensitivity and specificity is 80.7% and 79.3%.respectively,for each of the four protein markers tested.The AUC of the four protein markers combined detection strategy is 0.87(P < 0.05),and the sensitivity and specificity is 72.9% and 89%.Through this clinical trial,the feasibility of applying urinary tumor markers to clinical diagnosis guidance can be preliminarily evaluated,and the foundation can be laid for further multicenter and large sample clinical trials in the future.