| Objective: To analyze the expression of bladder specificity nuclear matrix protein 1(bladder cancer specific antigen 1,BLCA-1)in bladder cancer patients' serum and urine,and to explore the screening value of BLCA-1 in bladder cancer,and the correlations with clinical pathological characteristics of bladder cancer patients.Methods: 51 cases of patients with bladder cancer(bladder cancer group),44 cases of acute cystitis(cystitis patients group)and 25 cases of healthy person(control group)in our hospital during June 2015 to June 2017 were inclusion in this study,collecting the patients serum and urine samples,using the competitive enzyme-linked immunosorbent method(competitive enzyme-linked immunosorbent assay,C-ELISA)to detect the serum and urine BLCA-1 values.At the same time,the clinical pathological data of patients were collected,including general information(age,sex,contact information,etc),tumor pathology(infiltration depth,differentiation degree,pathological type,clinical stage,etc.)Establish a database and import into SPSS14.0statistics analysis software for data processing,compare the difference of BLCA-1values in serum and urine between three groups,and analyze the correlation of BLCA-1 levels in serum and urine with clinical pathological of patients with bladder cancer respectively.Adopting the receiver-operating characteristics(receiver operating characteristic curve,the ROC)curve method to analyze the screening and early diagnosis value of serum and urine BLCA-1 levels in patients with bladder cancer,determinly the cut off,sensitivity and BLCA-1 levels in serum and urine.Results: The expression level of serum BLCA-1 in bladder cancer group,the bladder inflammation group and control group were 6.21 ng/ml,2.14 ng/ml and 2.07 ng/ml,with statistical significance difference,Serum BLCA-1 level in bladder cancer group was significantly higher than that in cystitis group(P=0.002)and control group(P=0.004).while there was no statistical difference between cystitis group and control group(P=0.396).The expression level of urine BLCA-1 in bladder cancer group,the bladder inflammation group and control group were 0.96 ng/ml ? 0.41 ng/ml and0.39ng/ml,with statistical significance difference(P=0.036),The urinary BLCA-1level in bladder cancer group was significantly higher than that in cystitis group(P=0.029)and control group(P=0.033).while there was no statistical difference between cystitis group and control group(P=0.236).In bladder cancer patients,the serum BLCA-1 levels were associated with tumor infiltration depth and tumor staging,serum BLCA-1 level in muscularis invasive bladder cancer and middle-late bladder cancer patients were higher than that of nonmuscularis invasive and early bladder cancer patients,with statistically significant difference(P=0.007,P=0.013);There were no statistical difference of serum BLCA-1 between patients with different genders,ages,pathological types and differentiation.Clinical data analysis showed that the urine BLCA-1 levels were associated with tumor infiltration depth,urine BLCA-1 level in muscularis invasive bladder cancer patients were higher than that of nonmuscularis invasive bladder cancer patients,with statistically significant difference(P=0.029),There were no statistical difference of urine BLCA-1 between patients with different genders,ages,clinical stages,pathological types and differentiation.ROC curve analysis showed that,the area under the curve(area under cuver,AUC)of serum and urine BLCA-1 in diagnosis of bladder cancer were 0.889,95%CI(0.818,0.960)and 0.813,95%CI(0.737,0.888),the AUCs were between 0.7 ~ 0.9,achieved "relatively accurate" standard.The critical value of elevated serum BLCA-1(cut off)was 4.15 ng/ml,the sensitivity and speciality corresponding to youden index were 69.55% and 65.01% respectively.while the critical value of elevated urine BLCA-1(cut off)was 0.68 ng/ml,the sensitivity and speciality corresponding to youden index were 72.06% and 68.33% respectively.The sensitivity and speciality rate can reach to 80.04% and 77.25% when joint detection of BLCA-1 level in serum and urine applied to bladder cancer screening,were significantly increased compared with single detect.Conclusion: 1.The level of BLCA-1 in the serum and urine of bladder cancer patients were significantly increased.2.High serum and urine BLCA-1 levels are associated with the depth of tumor invasion.3.The BLCA-1 expression level in serum and urine have a certain value in noninvasive diagnosis of bladder cancer,combined detection of two indicators were more obvious,when patients' serum BLCA-1 > 4.15 ng/ml and urine BLCA-1 was beyond 0.68 ng/ml,should be more vigilant about bladder cancer,and given further histopathologic examination to confirm. |
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