Witjes J A, van der Poel H G, van Balken M R, Debruyne F M, Schalken J A
Department of Urology, University Hospital Nijmegen, The Netherlands.
Eur Urol. 1998;33(4):387-91. doi: 10.1159/000019621.
To study the value of two outpatient urine tests with regard to the diagnosis and recurrence of bladder tumors.
Fifty patients with a history of superficial bladder cancer were evaluated with urinary NMP22 levels (cutoff level 10 U/ml), bladder wash karyometry (low versus intermediate and high risk) and cystoscopy. All patients were followed for 1 year.
Diagnostic negative and positive predictive values (NPV and PPV) of the tests were, respectively: NMP22 91.2 and 56.3%, and karyometry 80 and 33.3%. Prognostic NPV and PPV with regard to a subsequent recurrence were, respectively: NMP22 77.8 and 27.3%, and karyometry 82.6 and 50%.
The diagnostic value of NMP22 is good. Since the 3 false-negative results were in low-stage and low-grade lesions, this test could be used as a prescreening for cystoscopy. The NPV of these tests with regard to tumor recurrence is around 80%, but only karyometry has a significant PPV. Change in the follow-up policy on the basis of these tests remains difficult. In patients with neobladders NMP22 appears to be of little use, because of the high urinary NMP22 levels in the absence of malignancy.
研究两种门诊尿液检查在膀胱肿瘤诊断及复发方面的价值。
对50例浅表性膀胱癌病史患者进行尿NMP22水平（临界值10 U/ml）、膀胱冲洗细胞计量法（低风险与中高风险）及膀胱镜检查评估。所有患者随访1年。
这些检查的诊断阴性和阳性预测值（NPV和PPV）分别为：NMP22为91.2%和56.3%，细胞计量法为80%和33.3%。关于后续复发的预后NPV和PPV分别为：NMP22为77.8%和27.3%，细胞计量法为82.6%和50%。
NMP22的诊断价值良好。由于3例假阴性结果出现在低分期和低级别病变中，该检查可作为膀胱镜检查的预筛查。这些检查关于肿瘤复发的NPV约为80%，但只有细胞计量法有显著的PPV。基于这些检查改变随访策略仍很困难。在新膀胱患者中，NMP22似乎用处不大，因为在无恶性肿瘤时尿NMP22水平也很高。
