Application of the NMP22 Test in the Diagnosis of Transitional Cell Carcinoma of the Urinary Bladder
摘要
This prospective study was designed to compare the results of the NMP22 test and urinary cytology for detection of transitional cell carcinoma (TCC) of the bladder. MATERIALS AND METHODS: Between January 2002 and July 2003, 29 patients with a history of superficial bladder cancer and 96 patients with urinary tract infection (UTI), benign prostate hyperplasia (BPH), or urolithiasis enrolled as the control group were included in the study. A fresh, midstream urine sample was collected and divided into 2 aliquots for cytological analysis and application of the NMP22 test before cystoscopy. The final diagnosis was confirmed by histology. RESULTS: The sensitivity in detecting bladder TCC was 86.2% for the NMP22 test and 51.7% for urinary cytology (p＜0.001). The specificity was 77.1% for the NMP22 test kit and 88.5% for urinary cytology (p＜0.001). Moreover, the sensitivity of the NMP22 test kit for grade 1 and 2 bladder cancer was significantly higher than that of urine cytology (71.4% vs. 14.3%, p＜0.05, 91.7% vs. 66.7%, p＜0.01, respectively). However, there were 22 patients with UTI, BPH, or urolithiasis who revealed a false-positive NMP22 test result, which produced a positive predictive value of 53.2%, while the negative predictive value was as high as 94.9%. CONCLUSIONS: The NMP22 test kit is a simple, noninvasive test and represents significantly better sensitivity over urinary cytology for the detection of bladder TCC. However, patients with suspicious bladder cancer associated with UTI, BPH, or urolithiasis and revealing a positive NMP22 test require further cystoscopic confirmation.