Using of Nmp 22 Only or Together With the Cytology in the Diagnosis and Follow-Up of Bladder Tumors

Abstract

Introduction: Nuclear Matrix Protein is a tumor marker using for early diagnosis and follow up of bladder cancer. This study was designed to determine the effectiveness of NMP 22 and cytology for early detection and follow up of bladder cancer. Material and Methods: Sixty-eight patients who were included in this study were divided in three groups. The first group comprised 46 patients with hematuria and lower urinary tract symptoms, who had no previous history of bladder cancer. Seventeen patients were included in the second group who treated by transurethral resection of bladder tumor, partial cystectomy or intracaviter chemotherapy. The third group consisted of 5 patients with bladder tumor previously. They refused any kind of treatment. A reference value of 15 U/ml was utilized for NMP 22 in urine. A positive outcome was a tumor seen in cystoscopic examination, which was later histopathologically confirmed as malignant. A negative outcome was tumor free cystoscopy, or benign histopathology of the suspected biopsy specimens. Urine cytology results were considered "malign" (severe dysplasia, malign and transitional cell carcinoma) and "benign" (metaplasia, inflamatory cells, dysplasia ). Results: Eighteen patients of the first group had bladder cancer, whereas NMP 22 was (+) in 29 patients in this group. However, NMP was (+) in 14 of the 18 patients with bladder tumor. The sensitivity and specificity of NMP 22 in group 1 were 77.7% and 46.6%, and that of cytology were 83.3% and 89.2% respectively. When all of the patients were evaluated together, the sensitivity and specificity of NMP 22 were 80.7% and 64.2%, and that of cytology were 88.4% and 90.4% respectively. Conclusion: In conclusion, this study indicates that NMP 22 reduces the necessity of cystoscopy, and it can be used as a screening test in combination with cytology.