核基质蛋白22在膀胱冲洗液细胞学检查中对膀胱癌风险分层的有效性

Nuclear Matrix Protein 22 in Voided Urine Cytology Efficacy in Risk Stratification for Carcinoma of Bladder.

作者信息

Sankhwar Monica, Singh Rajender, Sankhwar Satya Narayan, Goel Madhu Mati, Jain Amita, Sankhwar Pushp Lata

机构信息

Department of Urology King George Medical University, Lucknow, India.

Department of Division of Endocrinology, Central Drug Research Institute (Council of Scientific and Industrial Research), Chattar Manzil Palace Lucknow, India.

出版信息

World J Oncol. 2013 Jun;4(3):151-157. doi: 10.4021/wjon677w. Epub 2013 Jul 15.

DOI:10.4021/wjon677w

PMID:29147347

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5649780/

Abstract

BACKGROUND

To investigate the nuclear matrix protein NMP22 in voided urine for detection of malignancy in patients with risk factors of symptoms of bladder cancer.

METHODS

January 2009 to December 2012, participants included 1,331 patients at elevated risk for bladder cancer due to factors such as history of smoking or symptoms including hematuria and dysuria, patients at risk for malignancy of the urinary tract provided a voided urine sample for analysis of NMP22 protein and cytology prior to cystoscopy. The diagnosis of bladder cancer, based on cystoscopy with biopsy, was accepted as the reference standard. The performance of the NMP22 test was compared with voided urine cytology as an aid to cancer detection. Testing for the NMP22 tumor marker was conducted in a blinded manner.

RESULTS

Bladder cancer was diagnosed in 79 patients. The NMP22 assay was positive in 44 of 79 patients with cancer (sensitivity, 55.7%, 95% confidence interval (CI), 44.1-66.7%), whereas cytology test results were positive in 12 of 76 patients (sensitivity, 15.8%; 95% CI, 7.6-24.0%). The specificity of the NMP22 assay was 85.7% (95% CI, 83.8-87.6%) compared with 99.2% (95% CI, 98 initial endoscopy, including 3 that were muscle invasive and 1 carcinoma in situ.

CONCLUSION

The noninvasive point-of-care assay for elevated urinary NMP22 protein can increase the accuracy of cytoscopy, with test results available during the patient visit.

摘要

背景

研究排尿中核基质蛋白NMP22用于检测有膀胱癌症状风险因素患者的恶性肿瘤情况。

方法

2009年1月至2012年12月，参与者包括1331例因吸烟史或血尿、排尿困难等症状而有膀胱癌高风险的患者，有泌尿道恶性肿瘤风险的患者在膀胱镜检查前提供一份排尿样本用于分析NMP22蛋白和细胞学检查。基于膀胱镜检查及活检的膀胱癌诊断被视为参考标准。将NMP22检测的性能与排尿细胞学检查进行比较以辅助癌症检测。NMP22肿瘤标志物检测采用盲法进行。

结果

79例患者被诊断为膀胱癌。79例癌症患者中有44例NMP22检测呈阳性（敏感性为55.7%，95%置信区间（CI）为44.1 - 66.7%），而76例患者中有12例细胞学检查结果呈阳性（敏感性为15.8%；95% CI为7.6 - 24.0%）。NMP22检测的特异性为85.7%（95% CI为83.8 - 87.6%），而细胞学检查的特异性为99.2%（95% CI为98初始内镜检查，包括3例肌层浸润性和1例原位癌。