目的观察输尿管癌患者（upper tract urothelial carcinoma, UTUC）的 CT表现以及检测患者尿液中肿瘤标志物 Her2和uPA的表达情况，提高对输尿管癌 发病机理的了解和认识以及确诊的准确率 和特异度，为输尿管癌早期诊断和治疗 提供一定的指导意义。方法 收集自2011 年1月至今我院泌尿科经手术术后病理确 诊的UTUC患者22例，良性输尿管疾病(狭 窄、炎症等)20例，回顾性分析所有患者 的CT诊断结果；应用酶联免疫吸附实验 (ELISA)检测相应22例UTUC患者、20例良 性输尿管疾病患者尿液中肿瘤标志物Her2 和uPA的含量。结果 Her2和uPA在输尿管 癌患者尿液中的含量较良性输尿管疾病患 者有明显升高。CT诊断UTUC的准确率为 80%，特异度为70.8%；Her2和uPA的准确 率分别为70%，特异度分别为69.7%。三者 联合诊断的准确率可以达到100%，特异度 为95.3%。结论 CT结合Her2和uPA联合检 测，可明显增强对输尿管癌患者的术前诊 断准确率和特异度，对于病例的早期准确 诊断，患者术前制定恰当的手术方式等都 有重要指导意义。

Objective To detect the tumor markers expression of Her2 and uPA of urine in patients of Ureteral carcinoma (upper tract urothelial carcinoma, UTUC) and study the CT images of UTUC, to improve the understanding of ureteral carcinoma pathogenesis and cognition as well as the diagnosis accuracy and specific degrees, providing certain guiding significance with early diagnosis and treatment for ureteral carcinoma. Methods From January 2011 to now, 22 patients with UTUC (diagnosed by pathological examination)and 20 patients with Benign ureteral diseases were studied, retrospective analysis was applied for all the data including the resultsof CT and Her2 and uPA. Comprehensive assessments were used to study the diagnose effect of united use of CT and Her2 and uPA. Using enzyme-linked immunosorbent experiment (ELISA) test, to test 22 cases of UTUC and 20 cases of Benign ureteral diseases of Her2 and uPA content in the urine. Results Her2 and uPA content in the urine of patients with ureteral carcinoma patients with benign ureteral diseases have increased significantly. The diagnosis accuracy of CT for UTUC is 84.6%, which specificity is 70.8%; The diagnosis accuracy of Her2 and uPA is 70%, which specificity is 69.7%; The combined diagnosis accuracy is 100%, specificity is 95.3%. Conclusion CT combined with Her2 and uPA to diagnosis, can improve the diagnosis accuracy and specificity of UTUC, for early and accurate diagnosis, preoperative formulation of proper operation method, has important guiding significance.