目的 評價尿脫落細胞嗜銀染色結合B超聯(lián)合診斷膀胱移行細胞癌經尿道手術后復發(fā)的敏感性和特異性.
方法 采用盲法對每一納入研究對象同時進行尿脫落細胞嗜銀染色、經直腸B超和膀胱鏡檢查,以膀胱鏡結合病理檢查的結果為金標準,計算尿脫落細胞嗜銀染色結合B超聯(lián)合診斷膀胱癌經尿道手術后復發(fā)的敏感性、特異性和ROC曲線下面積.當尿脫落細胞嗜銀染色或/和B超陽性時,聯(lián)合診斷試驗的結果為陽性;當尿脫落細胞嗜銀染色和B超均陰性時,聯(lián)合診斷試驗的結果為陰性.
結果 納入148例膀胱移行細胞癌經尿道手術后1年以上的門診隨訪病例,其中57例復發(fā),復發(fā)率為38.51%.單用尿脫落細胞嗜銀染色診斷復發(fā)的敏感性和特異性是89.47% [95%CI(0.82,0.98)]和87.91% [95%CI(0.81,0.95)],ROC曲線下面積為82.22%.單用B超診斷復發(fā)的敏感性和特異性是57.90% [95%CI(0.45,0.71)] 和90.11% [95%CI (0.84,0.96)],ROC曲線下面積73.13%.當結合尿脫落細胞嗜銀染色和B超聯(lián)合診斷時,敏感性提高至94.74% [95%CI (0.89,1.00)],而特異性有所下降,為84.62% [95%CI (0.77,0.92)],ROC曲線下面積增加為98.28%.
結論 非侵入性的尿脫落細胞嗜銀染色結合B超聯(lián)合診斷膀胱移行細胞癌經尿道手術后復發(fā)的價值較高,可常規(guī)用于術后病例的隨訪.
引用本文： 魏 強,張慶江,張秀輝. 尿脫落細胞嗜銀染色結合B超聯(lián)合診斷膀胱癌經尿道手術后復發(fā). 中國循證醫(yī)學雜志, 2005, 05(9): 681-683. doi: 復制
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