Comparison of cytology and nuclear matrix protein 22 for the detection andfollow-up of bladder cancer

Objectives: This study was designed to determine the clinical usefulness of the nuclear matrix protein 22 (NMP 22) test for the detection of bladder c ancer in com pa risen to urine cytology. Methods: 84 patients suffering fro m bladder cancer or suspected bladder cancer, 25 patients with benign urolo gical lesions and 60 healthy controls participated in a prospective study, Freshly voided spot urine samples were taken for cytological examination an d determination of NMP 22 levels by enzyme-linked immunoassay. Results: The sensitivity of the NMP 22 test according to the tumor grading was (results of cytology in brackets): G1 25.0% (20.0%); G2 68.2% (59.1%), and G3 100.0 % (66.7); overall sensitivity was 62.5% (45.0%). The sensitivity for superf icial bladder cancer was 46.7% (36.7%) and for invasive bladder cancer 90.0 %(70.0%). The specificity was 65.9% (88.9%), Conclusions: NMP 22 is a relia ble tool for detecting invasive bladder cancer. Results for the frequently occurring low grade superficial bladder cancer are as poor as those obtaine d with cytology. In addition benign lesions such as urolithiasis or urinary tract infection lead to false-positive results. Therefore cystoscopy has t o be performed when trying to detect and follow-up bladder cancer. Copyrigh t (C) 2001 S. Karger AG, Basel.