Nuclear matrix protein-22: a prospective evaluation in a population at risk for bladder cancer. Results from the UroScreen study

作者：Huber Severine; Schwentner Christian^*; Taeger Dirk; Pesch Beate; Nasterlack Michael; Leng Gabriele; Mayer Thomas; Gawrych Katarzyna; Bonberg Nadin; Pelster Martin; Johnen Georg; Bontrup Heike; Wellhaeusser Harald; Bierfreund Hans Georg; Wiens Christian; Bayer Christian; Eberle Friedhelm; Scheuermann Bernd; Kluckert Mattias; Feil Gerhard; Bruening Thomas; Stenzl Arnulf

来源：BJU International, 2012, 110(5): 699-708.

DOI：10.1111/j.1464-410X.2011.10883.x

• bladder cancer
• early detection
• renal function
• NMP22
• haematuria

OBJECTIVE %26lt;br%26gt;To evaluate the value of nuclear matrix protein-22 (NMP22) in bladder cancer (BC) screening, and its effect on variables in a prospective study in a high-risk population. %26lt;br%26gt;PATIENTS AND METHODS %26lt;br%26gt;A total of 1772 chemical workers (mean age 62 years) exposed to carcinogenic aromatic amines were enrolled in the study. %26lt;br%26gt;In all, 7091 screening check-ups in 1609 subjects were performed. %26lt;br%26gt;Urine samples were collected for a quantitative NMP22 immunoassay, urine analysis and creatinine concentration assessment. %26lt;br%26gt;Cystoscopy and subsequent transurethral resection were performed where there were suspicious findings. %26lt;br%26gt;RESULTS %26lt;br%26gt;Histopathological analysis found three papillary urothelial neoplasms of low malignant potential, five recurrent BCs and 13 primary BCs. Three tumours were at a muscle-invasive stage (pT2, pT3a or pT3b). %26lt;br%26gt;We found higher NMP22 concentrations (%26gt; 10 U/mL) in 224 patients, which correctly predicted BC in six cases (sensitivity 97.29%, specificity 28.57%; negative predictive value 99.04%, positive predictive value 12.24%). %26lt;br%26gt;Gross haematuria affected NMP22 results (odd ratio [OR] 3.49, 95% confidence interval [CI] 1.81-6.73). Infection also affected NMP22 results (OR 4.13, 95% CI 2.31-7.35). %26lt;br%26gt;NMP22 was more frequently positive in urine with creatinine concentration %26gt; 2.5 g/L (OR 1.61, 95% CI 0.91-2.86). %26lt;br%26gt;CONCLUSIONS %26lt;br%26gt;NMP22 outcomes are affected by haematuria, infection and concentrated urine. %26lt;br%26gt;NMP22 alone cannot be recommended for primary screening in a high-risk population nor as an alternative to cystoscopy during follow-up. %26lt;br%26gt;A NMP22 test might be a useful adjunct to urine cytology.

• 出版日期2012-9