尿液中C反应蛋白含量和脏细胞癌的非侵入性分子分级
Jeremiah J Morrissey1, Marilee A Fisher1, Evan D Kharasch1
1Department of Anesthesiology, Division of Clinician and Translational Research, Washington University School of Medicine, St. Louis, Missouri 63110.
概括
尿液中C反应蛋白 (CRP) 在高度癌中显著升高,在手术后下降. 这种生物标志物可能有助于非侵入性地分级质,并预测转移风险.
科学领域:
- 尿瘤学 尿瘤学
- 生物标志物发现发现
- 细胞癌研究 细胞癌研究
背景情况:
- C-反应蛋白 (CRP) 是一种炎症标志物.
- 建议在癌组织中过度表达CRP.
- 尿中CRP在细胞癌 (RCC) 的诊断实用性尚未得到充分证实.
研究的目的:
- 为了确定尿液中CRP度是否在与对照组相比,在高度RCC患者中更高.
- 为了比较尿中CRP水平在RCC与其他泌尿癌和非癌症条件.
- 评估尿液CRP作为分类小质和预测转移的非侵入性工具的潜力.
主要方法:
- 观察性研究涉及87名患有小质 (≤4cm) 的患者,接受部分切除术.
- 瘤切除术前的尿液和血样本通过酶相关免疫吸收试验 (ELISA) 收集用于C反应蛋白测量.
- 术后病理证实了癌症类型 (清洁细胞/乳头RCC,血管脂瘤,染色恐惧症,细胞瘤) 和福曼等级. 随访52名RCC患者的尿液.
主要成果:
- 与对照人群相比,尿液CRP分别在1-2级和3-4级RCC中增加了17倍和80倍.
- 尿液CRP降低了85%的脏切除术后,表明瘤起源.
- 尿中CRP水平在其他脏瘤 (血管肌脂瘤,染色体恐惧症,细胞瘤) 和尿道癌 (膀,前列腺) 中低于高度RCC. 高诊断准确度 (C-统计值0.98) 用于区分RCC等级.
结论:
- 腎切除術前尿液CRP在高級清晰細胞和 papillary RCC中顯著升高,使其與其他腎臟和泌尿疾病有所區別.
- 尿CRP显示出作为一种非侵入性方法的潜力,用于在手术前对小质量进行分类.
- 尿中CRP升高可能预测未来细胞癌转移的风险.
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