NMP22 is predictive of recurrence in high-risk superficial bladder cancer patients

Abstract

Introduction: The nuclear matrix protein 22 (NMP22) assay has been shown to have greater sensitivity for the diagnosis and detection of recurrent urothelial carcinoma of the bladder (UCB) over that of traditional urine cytology. We assessed the use of NMP22 to predict which high-risk superficial UCB patients will have recurrence, progression or disease-related death; we compared these results to standard urine cytology. Methods:One hundred consecutive patients with high-risk superficial UCB were enrolled. During surveillance, urine was collected for cytology and NMP22 testing. Patients were followed for at least 6 months. Retrospective chart review was undertaken to collect data on previous tumour history, tumour characteristics, disease recurrences, progression and death. Kaplan-Meier analyses were performed to determine the significance between NMP22-positive and -negative patients in terms of recurrence-free, progression-free and overall survival. Similar analyses were performed for urine cytology. Results:From 94 eligible patients, 15 and 79 were NMP22 positive and negative, respectively. The baseline characteristics between the 2 groups were not significantly different in terms of patient characteristics, prior tumour history or intravesical therapies received. Mean recurrence-free survival time was significantly lower in the NMP22 positive group (p = 0.038); however, mean progression-free and overall survival were not significantly different between the 2 groups (p = 0.297 and 0.519, respectively). Urine cytology demonstrated no significant predictive power for disease recurrence, progression or survival. Conclusion:The nuclear matrix protein 22 assay appears to have predictive value for future tumour recurrences, but not progression or overall survival in patients with high-risk superficial UCB.Can Urol Assoc J 2009;3(6):454-8 RésuméIntroduction : Il a été montré que le test de dépistage de la protéine 22 de la matrice nucléaire (NMP22) présentait une sensibilité supérieure pour le diagnostic et le dépistage du carcinome urothélial récurrent de la vessie, en comparaison avec la cytologie urinaire classique. Nous avons évalué l'emploi de la NMP22 pour prédire la récurrence, la progression de la maladie et le décès relié à la maladie chez des patients atteints de carcinome urothélial de la vessie (CUV) superficiel et présentant un risque élevé. Les résultats ont été comparés à ceux obtenus avec une épreuve de cytologie urinaire standard.Méthodologie : Cent patients consécutifs présentant un CUV superficiel à risque élevé ont été inscrits à l'étude. Pendant la période de surveillance, un échantillon d'urine a été recueilli en vue de l'épreuve de cytologie et du test de dépistage de la NMP22. Le suivi a duré au moins 6 mois. Un examen rétrospectif des dossiers a fourni des données concernant les antécédents tumoraux, les caractéristiques de la tumeur, les récurrences, la progression et les décès. Des analyses de Kaplan-Meier ont été effectuées afin de déterminer le niveau de signification entre les pa...

The use of urinary nuclear matrix protein 22 (NMP22) as a diagnostic adjunct to urine cytology for monitoring of recurrent bladder cancer—institutional experience and review

“…Although, as recurrence‐associated factors, there were no associations between the pretreatment values of NMP22 and recurrence values . Most recent studies reported good negative predictive values (90–93%) indicating that a high proportion of individuals testing negative do not have bladder cancer . Another concern is serial measurements of NMP22.…”

“…In the study by Lau et al the data suggested that patients with high‐risk superficial UC who are NMP22 positive with negative cystoscopies are even more likely to recur than patients who are NMP22 negative. Thus, this might also identify a selected group of patients that should undergo intravesical therapy with maintenance …”

Serum-based protein biomarkers for detection of lung cancer

“…Based on accurate and early diagnosis of a disease, suitable treatment choices can be made. The US Food and Drug Administration (FDA) has approved bladder tumor antigen (BTA) and nuclear matrix protein-22 (NMP-22) [53] as diagnostic markers for bladder cancers based on urine analysis. De Petris et al [54] confirmed CYFRA21-1 as a diagnostic marker for lung cancer.…”

Research Progress in Potential Urinary Markers for the Early Detection, Diagnosis and Follow-up of Human Bladder Cancer

“…Lau et al assessed the use of NMP22 to predict which high-risk superficial UCB (urothelial carcinoma of the bladder) patients would have a recurrence, progression or diseaserelated death. According to their finding, they deem that the NMP22 assay appears to have predictive value for future tumour recurrences (Lau et al, 2009). Kundal et al assess the clinical utility of NMP22 Bladder Check Test and compare it with voided urine cytology and cystoscopy in early detection of bladder cancer.…”