评估尿NMP22水平作为pTa-pT1期膀胱癌诊断标志物的价值：与尿细胞学检查及BTA检测的比较

Evaluation of urinary level of NMP22 as a diagnostic marker for stage pTa-pT1 bladder cancer: comparison with urinary cytology and BTA test.

作者信息

Del Nero A, Esposito N, Currò A, Biasoni D, Montanari E, Mangiarotti B, Trinchieri A, Zanetti G, Serrago M P, Pisani E

机构信息

Institute of Urology, IRCCS, Ospedale Maggiore, Milan, Italy.

出版信息

Eur Urol. 1999 Feb;35(2):93-7. doi: 10.1159/000019825.

DOI:10.1159/000019825

PMID:9933801

Abstract

BACKGROUND

In the present study we compared the clinical value of two new specific tests for transitional cell carcinoma, urinary nuclear matrix protein (NMP22) levels and bladder tumor antigen (BTA) test, with that of urinary cytology in the follow-up of patients with superficial bladder cancer.

MATERIALS AND METHODS

Hundred and five bladder cancer patients were recruited: 30 stage pTa and 45 stage pT1 (group A), and 30 with a history of bladder cancer but no recurrence at the time of the study (group B). Urine samples were collected before any instrumental manipulation of the genitourinary tract. All patients were negative for urinary tract infections at conventional urine analysis.

RESULTS

NMP22 at a cutoff value of 6 U/ml showed a sensitivity of 83.3% in pTa cases and 97.7% in pT1 cases, with a false-positive rate of 23.3%. The BTA test was positive in 26.6% of patients with cancer stage pTa and in 66.6% of pT1 stage, with 30% false-positives in the non-neoplastic group. Urinary cytology, performed on three consecutive samples, was positive in 20% of patients with cancer stage pTa and in 64.4% of pT1 stage and did not show any false-positive cases. Stratifying the neoplastic patients according to lesion grade, NMP22 (at a cutoff value of 6 U/ml) was positive in 86.2% of G1, 97.2% of G2 and 90% of G3. BTA was positive in 37.9, 52.7 and 70% of G1, G2 and G3, respectively, while urinary cytology was positive in 37.9, 44.4 and 80%.

摘要

背景

在本研究中，我们比较了两种用于移行细胞癌的新型特异性检测方法——尿核基质蛋白（NMP22）水平检测和膀胱肿瘤抗原（BTA）检测，与尿细胞学检查在浅表性膀胱癌患者随访中的临床价值。

材料与方法

招募了105例膀胱癌患者：30例pTa期和45例pT1期（A组），以及30例有膀胱癌病史但在研究时无复发的患者（B组）。在对泌尿生殖道进行任何器械操作之前收集尿液样本。所有患者在常规尿液分析中均未检测出尿路感染。

结果

NMP22的临界值为6 U/ml时，在pTa期病例中的敏感性为83.3%，在pT1期病例中的敏感性为97.7%，假阳性率为23.3%。BTA检测在26.6%的pTa期癌症患者和66.6%的pT1期患者中呈阳性，在非肿瘤组中的假阳性率为30%。对连续三个样本进行的尿细胞学检查在20%的pTa期癌症患者和64.4%的pT1期患者中呈阳性，且未出现任何假阳性病例。根据病变分级对肿瘤患者进行分层，NMP22（临界值为6 U/ml）在G1级患者中的阳性率为86.2%，在G2级患者中的阳性率为97.2%，在G3级患者中的阳性率为90%。BTA在G1、G2和G3级患者中的阳性率分别为37.9%、52.7%和70%，而尿细胞学检查在G1、G2和G3级患者中的阳性率分别为37.9%、44.4%和80%。