Pérez García Francisco Javier, Eyo Ana, Escaf Barmadah Safwan, Fernández Gómez Jesús M
Servicio de Urología, Hospital San Agustín, Avilés, España.
Arch Esp Urol. 2002 Dec;55(10):1201-8.
1.--To evaluate the efficacy of the NMP-22 as a diagnostic test for bladder tumor recidives; 2.--To compare the efficacy of NMP-22 vs. urine cytology.
90 Patients with superficial bladder tumors were included in the study, undergoing cytologic, cystoscopic and NMP-22 marker controls. NMP 22 test was considered positive when the marker signal was higher than 10 U/ml. Cistoscopy was the reference test.
Patients in the study had an average age of 69 years, ranging from 45 to 91. 88% were males and 12% females. 61.2% of the tumors were Ta, 37.6% T1 and 1.2% Cis, being 17.8% grade I, 63.4% grade II and 18.8% grade III. NMP-22 showed a global sensitivity of 32.1%, and a specificity of 5.1%. Positive predictive value (PPV) was 75% and negative predictive value (NPV) 75.3% for a relapse rate of 27.7%. Urine cytology showed an overall sensitivity of 28.6%, 95.2% specificity, PPV 72.7% and NPV 74.7%. When both tests were used altogether sensitivity was 46.4%, specificity 90.3%, PPV 68.43% and NPV 78.9%.
The NMP-22 marker has shown low sensitivity so that control by cystoscopy may not be avoided. The combination of NMP-22 and urine cytology increases sensitivity minimally. It is not possible to replace cystoscopy in the follow-up of patients with superficial bladder tumors.
90例浅表性膀胱肿瘤患者纳入本研究，接受细胞学、膀胱镜检查及NMP-22标志物检测。当标志物信号高于10 U/ml时，NMP 22检测被视为阳性。膀胱镜检查为参照检测。
研究中的患者平均年龄69岁，年龄范围45至91岁。男性占88%，女性占12%。61.2%的肿瘤为Ta期，37.6%为T1期，1.2%为Cis期，其中I级占17.8%，II级占63.4%，III级占18.8%。NMP-22的总体敏感性为32.1%，特异性为5.1%。复发率为27.7%时，阳性预测值（PPV）为75%，阴性预测值（NPV）为75.3%。尿液细胞学检查的总体敏感性为28.6%，特异性为95.2%，PPV为72.7%，NPV为74.7%。两项检测联合使用时，敏感性为46.4%，特异性为90.3%，PPV为68.43%，NPV为78.9%。
NMP-22标志物敏感性较低，因此无法避免膀胱镜检查。NMP-22与尿液细胞学检查联合使用时，敏感性仅有轻微提高。在浅表性膀胱肿瘤患者的随访中，无法用其替代膀胱镜检查。
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