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Objective:To explore the changes of immune microenvironment and prognosis of bladder cancer patients with positive urinary nuclear matrix protein 22 (NMP22).Methods:Retrospective analysis was made on 86 patients who were diagnosed with bladder cancer in Xuzhou Central Hospital from January 2019 to September 2020. All patients were tested for urinary NMP22 by colloidal gold method. The patients with positive test results were NMP22 positive group, and the patients with negative test results were NMP22 negative group. The expression of CD8, programmed cell death-ligand 1 (PD-L1), programmed cell death protein-1 (PD-1) and PanCK were detected by multiple fluorescent immunohistochemical method on the pathological tissue sections of all enrolled patients with bladder cancer after surgery. Follow-up data of enrolled patients were collected after discharge, and univariate and multivariate Cox analysis was performed on the follow-up data.Results:There were 69 patients in the NMP22 positive group and 17 patients in the NMP22 negative group. The percentage of CD8 and PD-L1 positive cells in NMP22 positive group was significantly higher than that in NMP22 negative group, and the difference was statistically significant (all P<0.05). Univariate analysis showed that tumor stage was correlated with bladder cancer progression ( HR=2.67, P=0.017). Multivariate analysis showed that positive NMP22 was significantly correlated with bladder cancer recurrence and disease progression (all P<0.05). Conclusions:The density of CD8 + T cells and PD-L1 in tumor parenchyma of urinary NMP22 positive bladder cancer patients was higher than that of NMP22 negative patients. Urinary NMP22 positive can be one of the bad prognostic factors of bladder cancer, and the patients with NMP22 positive should strengthen reexamination.
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Objective To investigate the value of nuclear matrix protein 22(NMP22),cytokeratin 20(CK20) and survivin mRNA in the diagnosis of bladder cancer.Methods The research enrolled 107 cases with hematuresis or irritation sign of bladder,who were divided into the control group(44 cases) and the observed group(63 cases).Besides,45 health volunteers were chose as the health group.The urine level of NMP22 was detected by ELISA,and CK20 and survivin mRNA by RT-PCR to evaluate the value in the diagnosis of bladder tumor The sensitivities and specificities of NMP22,CK20 and survivin mRNA were compared and analyzed.Results The urine level of NMP22 in the observed group(37.92 U/mL) was obviously higher than that of health volunteers (4.31 U/mL) and the control group(7.04 U/mL).The difference was significant(P＜0.05).The sensitivity and specificity of NMP22 were 82.54％ and 61.36％ respectively,which was unrelated with the tumor stage.The sensitivities and specificities of CK20 and survivin mRNA were 83.70％,63.64％ and 85.71％,90.91％ respectively,which was positively related with the tumor stage.The sensitivities of CK20 and survivin mRNA in the T2-T4 subgroup were higher than that T1s-T1 subgroup.And there was statistic difference(P＜0.05).Conclusion There are significant evidences that the detections of NMP22,CK20 and survivin mRNA as non-invasive measures could be better methods and higher sensitivity and specificity in diagnosing bladder cancer.
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Objective To investigate the value of nuclear matrix protein 22(NMP22),cytokeratin 20(CK20) and survivin mRNA in the diagnosis of bladder cancer.Methods The research enrolled 107 cases with hematuresis or irritation sign of bladder,who were divided into the control group(44 cases) and the observed group(63 cases).Besides,45 health volunteers were chose as the health group.The urine level of NMP22 was detected by ELISA,and CK20 and survivin mRNA by RT-PCR to evaluate the value in the diagnosis of bladder tumor The sensitivities and specificities of NMP22,CK20 and survivin mRNA were compared and analyzed.Results The urine level of NMP22 in the observed group(37.92 U/mL) was obviously higher than that of health volunteers (4.31 U/mL) and the control group(7.04 U/mL).The difference was significant(P＜0.05).The sensitivity and specificity of NMP22 were 82.54％ and 61.36％ respectively,which was unrelated with the tumor stage.The sensitivities and specificities of CK20 and survivin mRNA were 83.70％,63.64％ and 85.71％,90.91％ respectively,which was positively related with the tumor stage.The sensitivities of CK20 and survivin mRNA in the T2-T4 subgroup were higher than that T1s-T1 subgroup.And there was statistic difference(P＜0.05).Conclusion There are significant evidences that the detections of NMP22,CK20 and survivin mRNA as non-invasive measures could be better methods and higher sensitivity and specificity in diagnosing bladder cancer.
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Objective To investigate a non-invative , sensitive and specific method to diagnose bladder cancer, and evaluate the value of the combination of FISH with NMP22 in the diagnosis of bladder cancer. Methods Urine from 68 patients suspected suffering from bladder cancer were used by FISH, NMP22 expression and cytologi-cal examination, respectively. The results of above detections were compared to the subsequent histopathology as-say to analyze the specicficity, sensitivity of diagnosis for bladder cancer. Results The sensitivity of FISH, NMP22 expression and the cytological examination was 81.4%,86.0% and 39.5% respectively, and the specifici-ty of FISH, NMP22 expression and the cytological examination was 84.0%, 72.0% and 96.0%, respectively. The sensitivity and specificity of the combination of FISH with NMP22 was 79.1% and 92.0%. Conclusions The combined diagnosis of FISH and NMP22 for bladder cancer showed greater sensitivity than that of the conventional cytology, with similar specificity as the conventional cytology. The combination of FISH with NMP22 test shows more value for the diagnosis of bladder cancer than any single assay.
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Objective To investigate the clinical applications of nuclear matrix protein 22 (NMP22) and urine cytology in early diagnosis,monitoringrecurrence and determining prognosis of bladder cancer.Methods Ninty-six urine specimens,including 45 cases before the resection of bladder cancer (pathologically confirmed),20 cases after the resection of bladder cancer and 31 cases with benign urinary tract condition,were both selected in detecting NMP22 by enzyme-linked i mmunosorbent assay (ELISA),and the results were compared with urinary cytology by x2 test.Results The NMP22 content of 45 cases before the resection of bladder cancer was 9.3 to 112.5 U/mL,the median was 48.7 U/mL.The NMP22 content of 31 cases with benign urinary tract condition was from 2.1 to 14.7 U/mL,the median was 7.9 U/mL.The NMP22 content of 20 cases after the resection of bladder cancer was from 4.3 to 18.7 U/mL,the median was 8.9 U/mL.The median of NMP22 before the resection of bladder cancer was significantly higher than the median in patients with benign urinary,the difference was statistically significant (P ＜0.05).Considering NMP22 ≥ 10 U/mL as the critical value,the sensitivity of the NMP22 in diagnosing bladder cancer was 82.2％ and the specificity was 70.9％.And the sensitivity of urine cytology was 31.1％ and the specificity was 100％.The recurrence of 9 cases was confirmed by cystoscopy in 20 cases after the resection of bladder cancer.Conclusion The NMP22 can be a effective biomarker in the early screeningand postoperative follow-up of bladder cancer.
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OBJECTIVES: Urine based tumor markers have uncertain utility in diagnosis or surveillance of patients with bladder cancer while cytology is commonly used. We evaluated whether cytology provides additional diagnostic information in patients with a negative NMP22® BladderChek® test (BladderChek) and negative cystoscopy. MATERIALS AND METHODS: We performed subset analyses of 2 large prospective multi-center databases evaluating BladderChek for UCB detection and surveillance. These cohorts were analyzed for presence of cancer and result of urine cytology in setting of a negative cystoscopy and negative BladderChek. Subsequently, we prospectively performed cystoscopy, cytology and BladderChek on 434 patients at our institution being evaluated for UCB. RESULTS: In the detection database (n = 1331), 1065 patients had a negative cystoscopy and BladderChek. There were 3 cancers (stages Ta, Tis and T1) and cytology was atypical in one and reactive in two. In the surveillance cohort (n = 668) patients, 437 patients had negative cystoscopy and BladderChek. Cancer was found in 2 patients (stages Tis and Ta). The patient with Tis has dysplastic cytology and Ta tumor had reactive cytology. In our cohort of 434 patients, 288 pts had negative cystoscopy and BladderChek. One cancer was missed, a Ta ureteral urothelial carcinoma with a reactive cytology. CONCLUSIONS: In patients with negative cystoscopy and BladderChek, very few cancers are missed and cytology was not effective in detection. Use of a point-of-care test in conjunction with cystoscopy in lieu of cytology could decrease cost, provide immediate results, improve negative predictive value and reduce the uncertainty that results from inconclusive cytologic results.
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Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Cystoscopy , Carcinoma, Transitional Cell/diagnosis , Nuclear Proteins/urine , Population Surveillance , Biomarkers, Tumor/urine , Urinary Bladder Neoplasms/diagnosis , Brazil , Carcinoma, Transitional Cell/urine , Point-of-Care Systems , Predictive Value of Tests , Prospective Studies , Risk , Sensitivity and Specificity , Urinary Bladder Neoplasms/urineABSTRACT
Objective To assess the feasibility of nuclear matrix protein 22(NMP22)and urinary bladder cancer,antigen (UBC) for the early diagnosis of bladder transitional cell carcinoma and its influencing factors.Methotis 105 subjects,including 60 patients of bladder cancer,25 patients of urological benign disease and 20 normal (healthy)individuals were enrolled in this study.Urine NMP22 and UBC wag assessed by enzyme-linked immunosorbent assay(ELISA).Urine NMP22 and UBC as well as exfoliocytology were conducted for the purpose to compare the sensitivity,specificity,positive and negative predictive value of these three ways.Results The sensitivity of NMP22(88.3%)and UBC(86.7%)were significantly better than exfolioeytology(40.0%,P<0.01).The specificity of NMP22,UBC and exfoliocytology were 80.0%,84.0%and 92.0%,respectively, the positive predictive values were 91.4%,92.9%and 92.3%,and the negative predictive values were 74.1%.72.4%and 38.9%.Conclusions NMP22 and UBC are sensitive,specific,simple,feasible and noninvasive diagnostic markers for the early detection of urinary bladder transitional cell cancer.
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PURPOSE: We evaluated the usefulness of the nuclear matrix protein 22 BladderChek (NMP22BC) test for the screening and follow-up of bladder cancer. MATERIALS AND METHODS: From February 2006 to September 2009, we enrolled 1,070 patients who had hematuria or who were being followed up for bladder cancer. We compared the sensitivity and specificity of the NMP22BC test with those of urine cytology. RESULTS: The sensitivity of the NMP22BC test (77.5%) was significantly higher than that of urine cytology (46.3%). The specificity of the NMP22BC test was 88.8%, compared with 97.9% for urine cytology. The sensitivity of the NMP22BC test (81.8%) in non-muscle-invasive bladder cancer was higher than that of cytology (36.4%). However, the sensitivity of the NMP22BC test and of urine cytology in invasive bladder cancer were 57.1% and 92.9%, respectively. The sensitivity of the NMP22BC test was higher for low-grade bladder cancer (83.9%) than for high-grade (62.5%), and the sensitivity of cytology was higher for high-grade bladder cancer (66.7%) than for low-grade (37.5%). Follow-up bladder cancer was detected in 262 patients. The sensitivity of the NMP22BC test in that group (72.7%) was decreased and the specificity (91.7%) was increased. The sensitivity of cytology (54.5%) in the follow-up group was increased and the specificity (95.6%) was decreased. The presence of pyuria was significantly associated with the lower specificity of the NMP22BC test. CONCLUSIONS: The greater sensitivity of the NMP22BC test may be more useful for the diagnosis of non-muscle-invasive bladder cancer and low-grade bladder cancer than for the diagnosis of invasive or high-grade bladder cancer. If the NMP22BC test is performed in the absence of pyuria, it may play a compensatory role for urine cytology.
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Humans , Follow-Up Studies , Hematuria , Mass Screening , Nuclear Matrix , Nuclear Proteins , Pyuria , Sensitivity and Specificity , Urinary Bladder , Urinary Bladder NeoplasmsABSTRACT
PURPOSE: We compared the efficacy of urine cytology, nuclear matrix protein 22 (NMP22), and fluorescence in situ hybridization (FISH) for the detection of bladder cancer. MATERIALS AND METHODS: Washing urine samples from 156 patients were evaluated for the detection of bladder cancer. Patients were divided into 3 groups. Group 1 was 106 patients with bladder cancer, group 2 was 30 patients with benign prostatic hyperplasia who underwent transurethral resection of the prostate without bladder cancer, and group 3 had gross hematuria without bladder cancer. The sensitivity and specificity of cytology, NMP22, and FISH were compared. NMP22 positivity was defined as > or =10U/ml. FISH was done with the UroVysion(R) system and FISH positivity was defined as > or =2 abnormal urothelial cells with an abnormal signal from any out of 4 probes. RESULTS: The overall sensitivity of urine cytology, NMP22, and FISH was 60.4%, 75.5%, and 84.9%, respectively (p<0.001). The overall specificity of cytology, NMP22, and FISH was 96.7%, 83.3%, and 93.3%, respectively (p=0.168). In group 3, the false-positive rates of cytology, NMP22, and FISH were 20.0%, 55.0%, and 10.0%, respectively. In these patients with gross hematuria, the false-positive rate with NMP22 was significantly higher than with cytology or FISH (p=0.004). The sensitivity of cytology, NMP22, and FISH in low-grade bladder cancer patients was 25.9%, 51.9%, and 77.8%, respectively, and that in pTa-1 bladder cancer patients was 40.6%, 65.6%, and 78.1%, respectively. In low-grade or in pTa-1 patients, the sensitivity of the three diagnostic tools was significantly different (low grade; p<0.001, pTa-1; p<0.001). CONCLUSIONS: FISH is more sensitive in low-grade bladder cancer than is urine cytology and can be used as a diagnostic tool for the detection of primary and recurrent bladder cancer. NMP22 was affected by gross hematuria and thus has limitations for screening of bladder cancer. However, it can be used to follow-up bladder cancer.
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Humans , Carcinoma, Transitional Cell , Fluorescence , Hematuria , In Situ Hybridization , In Situ Hybridization, Fluorescence , Mass Screening , Nuclear Matrix , Nuclear Proteins , Prostate , Prostatic Hyperplasia , Sensitivity and Specificity , Urinary Bladder , Urinary Bladder NeoplasmsABSTRACT
BACKGROUND: Screening of high-risk patients using bladder tumor markers can offer an advantage of early detection and saving medical costs. For these purpose many tumor markers have been developed to supplement invasive cystoscopy. Our study evaluated the NMP22 point-of-care test (NMP22 POCT), which is one of the tumor makers, comparing with the standard urine cytology for the diagnosis of bladder cancer. METHODS: From January to September 2005, 232 patients who had undergone a cystoscopy due to bladder cancer associated symptoms including hematuria and dysuria were enrolled in this study. Urine specimens were collected for NMP22 POCT and cytology. NMP22 POCT and urine cytology were compared for sensitivity and specificity. In addition, we evaluated urine stick test and microscopy to explain some false-positive results in NMP22 POCT. RESULTS: Superficial transitional cell carcinoma was diagnosed in 10 patients. The sensitivity of NMP22 test was 60% (95% confidence interval [CI], 26.2-87.8%), whereas that of cytology was 33.3% (95% CI, 7.5-70.1%); however, the difference was not significant. The specificity of NMP22 test was 69.8% (95% CI, 63.3-75.8%), compared with 99.0% (95% CI, 96.5-99.9%) for cytology (P<0.001). The presence of microscopic RBCs in urine specimen was significantly associated with the lower specificity of NMP22 POCT (P=0.02). CONCLUSIONS: NMP22 POCT was significantly less specific than urine cytology. To be useful as a bladder cancer screening test, the NMP22 test should have a higher specificity.
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Nuclear Proteins/urine , Point-of-Care Systems , Sensitivity and Specificity , Biomarkers, Tumor/urine , Urinary Bladder/pathology , Urinary Bladder Neoplasms/diagnosis , Urine/cytologyABSTRACT
PURPOSE: The aim of this study was to compare the sensitivity and specificity of the urinary survivin test for the diagnosis of bladder cancer with the nuclear matrix protein (NMP)-22 test and the urine cytology, and we wanted to correlate survivin with the tumor stage and grade. MATERIALS AND METHODS: Between October 2002 and March 2004, voided urine samples were obtained from 41 patients with bladder cancer and also from 36 controls who had no evidence of bladder cancer. The urinary survivin and NMP-22 levels were measured using a DuoSet IC ELISA kit and an automated chemiluminescent assay system. The results were compared with the cytologic results and the pathologic findings. RESULTS: The comparative results showed the higher sensitivity for the urinary survivin test (78.0%) and the NMP-22 test (75.6%) than for the urine cytology (65.8%) for the detection of bladder cancer. The specificity of urinary survivin (86.1%) and urine cytology (97.2%) were higher than that for the NMP-22 test (66.6%). Measuring the urinary survivin level was a more accurate test than the urinary NMP-22 test and the urine cytology for the detection of lower grade and superficial bladder cancer. CONCLUSIONS: The urinary survivin test was superior to urine cytology for sensitivity and specificity, and these two parameters of the urinary survivin test were higher than those of the NMP-22 test. Especially, the urinary survivin test is an accurate diagnostic test for superficial and lower grade bladder tumor. Our results suggested that the urinary survivin test appears to be a reliable diagnostic test to identify patients with bladder cancer.
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Humans , Diagnosis , Diagnostic Tests, Routine , Enzyme-Linked Immunosorbent Assay , Luminescent Measurements , Nuclear Matrix , Sensitivity and Specificity , Urinary Bladder Neoplasms , Urinary BladderABSTRACT
Objective To evaluate the quantitative determination of urine nuclear matrix protein 22 (NMP-22) and bladder tumor antigen (BTA) in the screening of bladder tumor recurrence. Methods 90 patients who had undergone TURBT were recruited in this study.Standard ELISA test was used to determine the quantity of NMP-22 in urine and urine BTA stat test was also performed.the findings were analyed with reference to the cystoscopic and pathological results. Results In comparison with the results of cystoscopy,urine NMP-22 test might denote 77% (32/43) recurrence of bladder cancer and this positive rate would increase to 93% (40/43) with the combined use of urine NMP-22 and BTA test. Conclusions Examination of NMP-22 in urine is a rapid and effective means of detecting the recurrence of bladder cancer.With the combined use of BTA test,urine NMP-22 determination might be a useful non-invasive method in screening the recurrence of bladder cancer,and the conventional invasive cystoscopy might be avoided.