摘要
目的探讨膀胱癌中陷阱受体3（DcR3），Bcl-2和PCNA及其联合检测的诊断价值。方法应用免疫组织化学技术检测224例膀胱癌组织标本和56例正常膀胱组织标本中DcR3，Bcl-2和PCNA的表达，并应用受试者工作特征曲线（ROC）分析三项指标及联合检测对膀胱癌诊断的临床价值。结果膀胱癌组中DcR3，Bcl-2和PCNA的表达均明显高于正常膀胱组织（均P〈0．05）。DcR3的表达与膀胱癌的病理分级、是否浸润、淋巴结转移和复发相关（P〈0．05）；Bcl-2的表达与膀胱癌的淋巴结转移相关（P〈0．05）；PCNA的表达与膀胱癌的病理分级和淋巴结转移相关（P〈0．05）。DcR3表达水平和Bcl-2及PCNA呈正相关关系，Bcl-2和PCNA也同样呈正相关关系（P〈0．05）。DcR3，Bcl-2及PCNA联合检测的曲线下面积（AUC）高于单独指标检测值。联合检测DcR3＋PCNA，Bcl-2＋PCNA及DcR3＋Bcl-2＋PCNA的灵敏度均优于单独检测，其中最高者为三者联合组，灵敏度为0．830。联合检测DcR3＋PCNA，Bcl-2＋PCNA及DcR3＋Bcl-2＋PCNA的阳性预测值分别为100％，96．2％，100％，也均高于单独检测。结论DcR3，Bcl-2，PCNA三者联合检测可显著提高膀胱癌诊断的灵敏度和阳性预测值，优于单项检测效果。
Objective To explore the combinatorial diagnostic value of Decoy receptor 3 （DcR3）, B-cell lymphoma-2 （Bcl-2） and proliferating cell nuclear antigen （PCNA） in bladder cancer tissues. Methods Immunohistochcmistry （IHC） was performed to detect the expression of DcR3, Bcl-2 and PCNA in 224 cases bladder cancer tissues and 56 cases normal bladder tissues. Receiver operating characteristic （ROC） curve was applied to analyze the clinicopathological diagnostic value of the aforementioned 3 biomarkers individually or combinatorially. Results The expressions of DcR3, Bcl-2 and PCNA in bladder cancer were significantly higher than those in normal control （all P 〈 0.05）. The DcR3 level had positive correlations with pathological stages, invasion, lymphatic metastasis and recurrence （all P 〈 0.05）. The expression of Bcl-2 was related to lymphatic metastasis in bladder cancer （P 〈 0.05）. The expression of PCNA had a correlation with pathological stage and lymphatic metastasis （both P 〈 0.05）. DcR3 expression level was associated with that of Bcl-2 and PCNA, whereas Bel-2 also had consistent correlation with PCNA （P 〈 0.05）. The areas under the curve （AUCs） of DcR3, Bcl-2 and PCNA were higher than the individual level of each marker. The combination of DeR3＋PCNA, Bel-2＋PCNA and DcR3＋Bcl-2＋PCNA offered higher sensitive values than single marker. The highest sensitive value was 0.830, produced by the combination of DcR3＋Bcl-2＋PCNA. The combination of DeR3＋PCNA （100%）, Bcl-2＋PCNA （96.2%） and DeR3＋Bcl-2＋PCNA （100%） had higher positive predictive values than single markers. Conclusion Combined detection by immunohistochemistry of DcR3, Bcl-2 and PCNA could noticeably improve the sensitivity and positive predictive values in the diagnosis of bladder cancer, which is superior to individual marker.
出处
《国际医药卫生导报》
2014年第23期3520-3525,共6页
International Medicine and Health Guidance News
基金
广西大学生创新创业计划（201410598004）
关键词
膀胱癌
陷阱受体3
BCL-2
PCNA
免疫组化
ROC曲线
Bladder cancer
Decoy receptor 3
B-cell lymphoma-2
Proliferating cell nuclear antigen
Immunohistoehemistry
Receiver operating characteristic curve
