尿细胞学检查和核基质蛋白22在检测除移行细胞癌以外的膀胱癌复发中的应用

Urinary cytology and nuclear matrix protein 22 in the detection of bladder cancer recurrence other than transitional cell carcinoma.

作者信息

Hutterer Georg C, Karakiewicz Pierre I, Zippe Craig, Lüdecke Gerson, Boman Hans, Sanchez-Carbayo Marta, Casella Roberto, Mian Christine, Friedrich Martin G, Eissa Sanaa, Akaza Hideyuki, Serretta Vincenzo, Hedelin Hans, Rupesh Raina, Miyanaga Naoto, Sagalowsky Arthur I, Perrotte Paul, Lotan Yair, Marberger Michael J, Shariat Shahrokh F

机构信息

Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Quebec, Canada.

出版信息

BJU Int. 2008 Mar;101(5):561-5. doi: 10.1111/j.1464-410X.2007.07352.x.

DOI:10.1111/j.1464-410X.2007.07352.x

PMID:18257856

Abstract

OBJECTIVE

To assess the value of nuclear matrix protein-22 (NMP22), compared with urinary cytology, in predicting the recurrence of bladder cancer that is not transitional cell carcinoma (non-TCC).

PATIENTS AND METHODS

We tested the sensitivity, specificity and the predictive accuracy of NMP22 in the context of non-TCC bladder cancer recurrence, and compared it to the performance of urinary cytology. The study group comprised 2687 patients with history of non-muscle-invasive bladder cancer from 10 centres across four continents.

RESULTS

The mean patient age was 64.8 years and 75.4% were men; of all patients, 513 (19.1%) had positive urinary cytology, 906 (33.7%) had a positive NMP22 test (>or=10 units/mL) and 80 (3.0%) had non-TCC recurrence. Most of these, i.e. 60 (75%), were stage >or=T2. The sensitivity and specificity of urinary cytology were, respectively, 20.0% and 94.8%, vs 77.5% and 81.8% for NMP22 of >or=10 units/mL. The predictive accuracy of urinary cytology was 57.5%, vs 87.1% for NMP22 >or= 10 units/mL. A combined model that included dichotomized NMP22 and urinary cytology was 85.3% accurate.

CONCLUSION

The ability of a NMP22 level of >or=10 units/mL to predict non-TCC recurrence was better than that of urinary cytology, suggesting that NMP22 might have a role in the surveillance of patients at risk of non-TCC recurrence.

摘要

目的

评估核基质蛋白-22（NMP22）与尿细胞学检查相比，在预测非移行细胞癌（非TCC）膀胱癌复发方面的价值。

患者与方法

我们检测了NMP22在非TCC膀胱癌复发情况下的敏感性、特异性和预测准确性，并将其与尿细胞学检查的性能进行比较。研究组包括来自四大洲10个中心的2687例非肌层浸润性膀胱癌患者。

结果

患者平均年龄为64.8岁，75.4%为男性；所有患者中，513例（19.1%）尿细胞学检查呈阳性，906例（33.7%）NMP22检测呈阳性（≥10单位/毫升），80例（3.0%）出现非TCC复发。其中大多数，即60例（75%）为≥T2期。尿细胞学检查的敏感性和特异性分别为20.0%和94.8%，而NMP22≥10单位/毫升时分别为77.5%和81.8%。尿细胞学检查的预测准确性为57.5%，而NMP22≥10单位/毫升时为87.1%。包含二分法NMP22和尿细胞学检查的联合模型准确率为85.3%。