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The Value of Insulin-like Growth Factor 2 in Urinary Exosomes of Bladder Urothelial Carcinoma
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摘要:
目的 探究膀胱尿路上皮癌患者尿液外泌体中胰岛素样生长因子2(insulin-like growth factor 2，IGF2)表达情况，评估其诊断膀胱尿路上皮癌的临床价值。 方法 前瞻性选取2020年9月至12月北京协和医院诊治的膀胱尿路上皮癌患者和非尿路上皮癌患者为研究对象。采用荧光定量反转录PCR法检测两组尿液外泌体中IGF2表达水平。以病理结果为金标准，计算尿液外泌体中IGF2诊断膀胱尿路上皮癌的灵敏度、特异度、阳性似然比和阴性似然比。 结果 共入选符合纳入和排除标准的膀胱尿路上皮癌患者35例，非尿路上皮癌患者60例。膀胱尿路上皮癌患者尿液外泌体中IGF2阳性表达率显著高于非尿路上皮癌患者(71.4%比10.0%，P=0.000)。尿液外泌体中IGF2诊断膀胱尿路上皮癌的灵敏度为71.43%(95% CI：53.48%~84.76%)、特异度为90.00%(95% CI：78.83%~95.87%)、阳性似然比为7.14(95% CI：3.25~15.70)、阴性似然比为0.32(95% CI：0.19~0.54)。 结论 膀胱尿路上皮癌患者尿液外泌体中IGF2呈高表达，其对膀胱尿路上皮癌具有较高的诊断特异度，但灵敏度稍低，有望作为膀胱尿路上皮癌的初筛指标。 Abstract:Objective To explore the expression of insulin-like growth factor 2 (IGF2) in urinary exosomes of patients with bladder urothelial carcinoma, and to evaluate its clinical value in the diagnosis of bladder urothelial carcinoma. Methods Patients with bladder urothelial carcinoma or non-urothelial carcinoma diagnosed and treated by Peking Union Medical College Hospital from September to December 2020 were prospectively selected as the research subjects. Fluorescence quantitative reverse transcription PCR was used to detect the expression levels of IGF2 in the urine exosomes of the two groups. The sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of IGF2 in urinary exosomes for diagnosing bladder urothelial carcinoma were calculated, using pathological results as the gold standard. Results A total of 35 patients with bladder urothelial carcinoma and 60 non-urothelial carcinoma patients who met the inclusion and exclusion criteria were selected. The positive expression rate of IGF2 in urinary exosomes in patients with bladder urothelial carcinoma was significantly higher than that in patients with non-urothelial carcinoma (71.4% vs. 10.0%, P=0.000). The sensitivity of IGF2 in urinary exosomes for diagnosing bladder urothelial carcinoma was 71.43% (95% CI: 53.48%-84.76%), the specificity was 90.00% (95% CI: 78.83%-95.87%), the positive likelihood ratio was 7.14 (95% CI: 3.25-15.70), the negative likelihood ratio was 0.32 (95% CI: 0.19-0.54). Conclusions IGF2 is highly expressed in urinary exosomes of patients with bladder urothelial carcinoma, which has high diagnostic specificity for bladder urothelial carcinoma, but a slightly lower sensitivity. IGF2 is expected to be used as a primary screening index for bladder urothelial carcinoma. -
Key words:
- bladder urothelial carcinoma /
- exosomes /
- insulin-like growth factor 2
作者贡献：杨庭楷负责标本收集、实验室检查、数据分析、文献调研、文章撰写；纪志刚负责提供实验思路与实验设计；文进负责提供实验思路、实验设计以及论文审校。利益冲突：所有作者均声明不存在利益冲突 -
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