Urinary NMP22 and BTA tests as screening markers for bladder transitional cell carcinoma / 대한임상병리학회지

ABSTRACT

BACKGROUND: Urinary bladder cancer has been diagnosed by urine cytology and cystoscopy with biopsy. Recently, in vitro noninvasive diagnostic tests, measuring urinary nuclear matrix protein22(NMP22) and bladder tumor antigen(BTA), were introduced. We analyzed the usefulness of the NMP22 and BTA tests for diagnosing bladder cancer and compared those with voided urine cytology. MATERIALS AND METHODS: Single voided urine specimens were obtained from 27 patients with bladder cancer and 23 healthy volunteers. The urine specimens were assayed by enzyme immunoassay(NMP22, Matrietech(R), Newton, MA.) and latex immunoassay(BTA, Bard, USA). Urine cytology was performed in patients with bladder cancer. RESULTS: Mean urinary NMP22 level of patients with bladder cancer(144.6 U/mL) was significantly higher than those of normal controls(2.9 U/mL, P<0.01). The sensitivities were 89% and 74% for NMP22 and BTA tests, respectively, compared with 41% for voided urine cytology. The sensitivities of NMP22 and BTA tests were 88%, 63% at grade 1(G1), 82%, 73% at G2, and 100%, 88% at G3, respectively(P<0.01; NMP22, P=0.580; BTA). According to tumor stage, the sensitivities of NMP22 and BTA tests were both 79% at superficial, and 100% and 69% at invasive cancer, respectively(P=0.110; NMP22, P=0.678; BTA). The sensitivities of urine NMP22 and BTA tests combined with urine cytology were both 96%. In following of transitional cell carcinoma patients, agreement between urine cytology and BTA test was 75%(24/32). Among the various urologic disease, false positive rate for BTA test was 17%(8/47). CONCLUSION: Urinary NMP22 and BTA tests were more sensitive than voided urine cytology regardless of tumor grade and stage, so these noninvasive and simple tests can be used as screening tests for urinary bladder transitional cell carcinoma.