Use of the nuclear matrix protein 22 Bladder Chek test™ in the diagnosis of residual urothelial cancer before a second transurethral resection of bladder cancer

Abstract

Purpose

To investigate the diagnostic value of the nuclear matrix protein 22 (NMP-22) in residual tumors after complete transurethral resection (TUR) of bladder cancer.

Methods

A total of 160 patients diagnosed with non-muscle invasive bladder cancer were prospectively enrolled in the study. Before the initial TUR, the patients were evaluated using urine cytology and the NMP-22 Bladder Chek™. After 4–6 weeks, all patients underwent a second TUR, urine cytology and NMP-22 Bladder Chek™ evaluation.

Results

The mean patient age was 59.8 ± 1.0 years. Of the 160 patients, 81 (50.6 %) had positive NMP-22 findings and 53 (33.1 %) had positive urine cytology findings. In 101 (63.1 %) patients, at least one marker was positive. There was no correlation between the positivity ratio of the NMP-22 and the degree of risk group (p = 0.156); however, in the high-risk group, the malignant cytology ratio was higher (p < 0.001). In 60 patients (37.5 %), there were tumors in the second TUR. NMP-22 results of 40 of these patients (66.7 %) were positive, and for 28 (46.7 %), the cytology results were positive. The sensitivity, specificity, positive predictive value, and negative predictive value of the NMP-22 alone was 66.7, 81, 67.8, and 80.2 %, respectively; for the cytology, it was 46.7, 98, 93.3, and 75.4 %, respectively; and for the NMP-22 and cytology combined, it was 73.3, 79, 67.7, and 83.2 %, respectively.

Conclusions

NMP-22 Bladder Chek™ test has limited efficacy in detecting residual tumors before a second TUR. The combination of this test with cytology has no additional benefit.