Lee M Y, Tsou M H, Cheng M H, Chang D S, Yang A L, Ko J S
Department of Pathology and Laboratory Service, Koo Foundation, Sun Yat-Sen Cancer Center, Taipei, Taiwan.
World J Urol. 2000 Dec;18(6):401-5. doi: 10.1007/s003450000124.
For evaluation of the clinical application of immunoassay for nuclear matrix protein 22 (NMP22 immunoassay) and urinary cytology for early diagnosis and detection of bladder cancer in patients with hematuria and/or a previous history of bladder cancer, 209 urine samples obtained from 137 patients presenting episodes of hematuria or a history of bladder cancer were assayed for NMP22 levels and/or prepared for cytology examination. Biopsy was performed when any visible tumor was identified during cystoscopy examination. The median NMP22 concentrations measured in samples taken from patients with active bladder cancer, from patients with a history of bladder cancer but no active disease, from patients with hematuria, and from healthy volunteers were 18.95, 5.45, 6.39, and 3.75 U/ml, respectively. The urinary NMP22 level recorded for patients with urothelial carcinoma was significantly higher than that noted for individuals without active disease. The sensitivity of the NMP22 assay and of urinary cytology in diagnosing bladder cancer was 69% and 67%, respectively. In contrast, the specificity of these two diagnostic modalities reached 72% and 93%, respectively. The NMP22 assay is slightly more sensitive but less specific than urinary cytology in detecting bladder cancer. This study indicates that determination of urinary NMP22 levels is a useful and noninvasive tool for the detection of bladder cancer because of its high sensitivity. The urinary NMP22 assay may be used as a first-line routine screening method; however, it cannot replace the use of urinary cytology because of its lower specificity.
为评估核基质蛋白22免疫测定法（NMP22免疫测定）及尿细胞学检查在血尿和/或既往有膀胱癌病史患者中早期诊断和检测膀胱癌的临床应用，对137例出现血尿或有膀胱癌病史的患者所采集的209份尿液样本进行了NMP22水平检测和/或制备用于细胞学检查。在膀胱镜检查中发现任何可见肿瘤时均进行活检。从患有活动性膀胱癌的患者、有膀胱癌病史但无活动性疾病的患者、血尿患者及健康志愿者采集的样本中测得的NMP22浓度中位数分别为18.95、5.45、6.39和3.75 U/ml。尿路上皮癌患者的尿NMP22水平显著高于无活动性疾病个体的水平。NMP22检测法及尿细胞学检查诊断膀胱癌的敏感性分别为69%和67%。相比之下，这两种诊断方法的特异性分别达到72%和93%。在检测膀胱癌方面，NMP22检测法比尿细胞学检查稍敏感，但特异性较低。本研究表明，由于尿NMP22水平检测具有高敏感性，因此它是检测膀胱癌的一种有用且非侵入性的工具。尿NMP22检测可作为一线常规筛查方法；然而，由于其特异性较低，它不能替代尿细胞学检查。
