目的：检测膀胱癌患者手术前后血清前梯度蛋白2(anterior gradient 2，AGR2）的水平变化，并探讨其预后判断价值。方法:采集厦门大学附属成功医院2013年6月至2015年12月40例行手术治疗的膀胱癌患者（膀胱癌组）和20例健康体检者（对照组）外周静脉血，采用ELISA法检测血清AGR2水平，分析血清AGR2水平与膀胱癌临床病理特征及预后的关系。结果：膀胱癌组患者术前血清AGR2水平明显高于正常对照组\[（28.93±6.03）vs（10.20±3.76）ng/ml, P<0.01\]，术后血清AGR2水平明显低于手术前\[（16.63±4.31）vs （28.93±6.03）ng/ml, P<0.01]；患者术前血清AGR2水平与临床病理分期、淋巴结转移有关（P<0.05或P<0.01），术前血清AGR2＞27.9 ng/ml组中位患者PFS与OS均明显低于≤27.9 ng/ml 组（P<0.05）；COX模型多因素分析结果显示，病理分期、淋巴结转移以及不同AGR2水平是影响膀胱癌患者预后的独立危险因素（P＜0.05）。结论: 膀胱癌患者血清AGR2水平增高，其与膀胱癌的恶性生物学行为有关，术前检测血清AGR2水平对于判断膀胱癌患者预后有一定临床价值。

Objective:To determine the change of serum anterior gradient2 (AGR2) level before and after surgery in bladder cancer patients, and to investigate its significance in predicting prognosis. Methods:The peripheral venous blood samples were collected from 40 patients with bladder cancer who accepted surgery (bladder cancer group) and 20 healthy controls (control group).The level of serum AGR2 was detected by enzyme linked immunosorbent assay (ELISA). The relationship between the level of serum AGR2 and clinicopathologic characteristics as well as prognosis prediction of bladder cancer was analyzed. Results: The level of serum AGR2 in the patients with bladder cancer was significantly higher than that in normal controls (\[28.93±6.03\] vs \[10.20±3.76\] ng/ml, P<0.01\]. The preoperative level of serum AGR2 in the patients was significantly lower than that of postoperative level (\[16.63±4.31\] vs \[28.93±6.03\] ng/ml, P<0.01). The preoperative level of serum AGR2 was closely correlated with lymph node metastasis and clinical pathologic staging (P<0.01 or P<0.05). The median progression free survival (PFS) and median overall survival (OS) in high level of serum AGR2 group (AGR2＞27.90 ng/mL group) were lower than those in low level of serum AGR2 group (AGR2≤27.90 ng/ml group), respectively (all P<0.05). COX multivariance regression model showed that clinical stages, lymph node metastasis and different level of serum AGR2 were independent risk factors that influence the prognosis of bladder cancer patients (P<0.05). Conclusion: Serum AGR2 in bladder cancer patients was higher, which closely related to malignant biological behavior of bladder cancer. It is of clinical significance to detect the level of serum AGR2 before operation for judging the prognosis of patients with bladder cancer.