目的 动态检测膀胱癌患者手术前、后尿Livin mRNA 表达情况，探讨其对膀胱癌早期诊断的临床价值。方法 采用实时荧光定量PCR 方法检测30 例膀胱移行细胞癌患者术前、术后1 周、1 个月、3 个月、6 个月至18 个月及30 例 非泌尿系统肿瘤患者及30 例健康志愿者尿Livin mRNA 表达情况，并结合临床资料进行分析。结果  Livin mRNA 在 30 例 病例组术前尿液中出现高表达，相对拷贝数为（96.33±35.79）/ul，且随着肿瘤临床分期、分级由低到高，其表达水平亦有 随之增加的趋势；30 例对照组中有2 例出现较高表达，相对拷贝数分别为43.17 和 47.52，其余为低表达，相对拷贝数为 （16.25±7.81）/ul；30 例正常组为低表达，相对拷贝数为 13.74±1.57。病例组术前尿 Livin mRNA 表达水平明显高于对照组 和正常组，其差异有统计学意义（P＜0.05）；术后 1周（ 27.35±2.21）/ul较术前显著下降（P＜0.05）；术后 1个月（ 16.72±2.45） /ul、3 个月（15.54±2.14）/ul、6 个月（14.33±1.71）/ul 与对照组和正常组相比差异无统计学意义（P ＞ 0.05）。随访至术 后 18 个月，5 例复发者再次手术前（98.27±26.55）/ul 与初次术后6 个月相比差异有统计学意义（P ＜ 0.05）。结论  动态 检测尿 Livin mRNA 表达的高特异性、高敏感性，可作为膀胱癌早期诊断的一个无创性指标。

Objective Dynamic detection of urinary Livin mRNA expression in patients with bladder cancer before and after operation and its clinical value in early diagnosis of bladder cancer. Methods Urine of 30 patients with initially diagnosed BTCC was collected before operation and one week, one month, three months, six months and 18 months after operation. Urine of 30 healthy volunteers and 30 Non-urological cancer patients was collected. Expression of survivin mRNA in urine exfoliated cells was detected by real-time PCR. Results Livin mRNA was highly expressed in the urine of 30 patients before operation, and the relative copy number was (96.33±35.79), and the expression level increased with the clinical stage and grade of the tumor from low to high; 2 of 30 patients in the control group showed high expression, the relative copy number was 43.17 and 47.52, the other was low expression, and the expression level was low. The copy number was (16.25±7.81); 30 cases in normal group were low expression, and the relative copy number was (13.74±1.57). The expression of Livin mRNA in urine of the case group was significantly higher than that of the control group and the normal group (P<0.05); the expression of Livin mRNA in urine of the case group was significantly lower than that of the control group (P<0.05); the expression of Livin mRNA in urine of the case group was significantly lower than that of the normal group (P<0.05); there was no significant difference between the control group and the normal group (P>0.05). Follow-up to 18 months after surgery, 5 patients with recurrence before reoperation (98.27±26.55) and 6 months after the initial operation were significantly different (P<0.05). Conclusion Dynamic detection of urinary Livin mRNA expression with high specificity and sensitivity can be used as an important noninvasive marker for early diagnosis of bladder cancer.