Urinary UBC Rapid and NMP22 Test for Bladder Cancer Surveillance in Comparison to Urinary Cytology: Results from a Prospective Single-Center Study

Abstract

Background: Non-muscle invasive bladder cancer (NMIBC) is associated with high rates of recurrence, resulting in frequent follow-up cystoscopies. We evaluated the use of two point-of-care tests - the nuclear matrix protein 22 (NMP22) and urinary bladder cancer antigen (UBC) Rapid - compared to routine follow-up in patients with a previous history of NMIBC. Methods: 31 patients with cystoscopy-verified active bladder cancer, and 44 follow-up patients without disease as confirmed by cystoscopy were prospectively enrolled. All urine samples were analyzed by voided urine and bladder washing cytology, NMP22 and UBC rapid test (qualitatively and quantitatively). The best cutoff (highest Youden index; ≥6.7 ng/ml) for the quantitative UBC was determined by receiver operating characteristic curves. Results: Voided urine and barbotage cytology resulted in a sensitivity of 25.8% and 32.3%, and a specificity of 100% and 100%, while the NMP22 showed a sensitivity and specificity of 12.9% and 100%, respectively. The qualitative and quantitative UBC Rapid revealed a sensitivity of 61.3% and 64.5%, with a specificity of 77.3% and 81.8%. Barbotage cytology and qualitative UBC test proved to be the best dual combination with the highest overall sensitivity (77.4%). In contrast to barbotage cytology alone, sensitivity increased from 21.4% to 50% for detecting low-grade tumors, and from 43.8% to 100% for high-grade cancers, but reducing specificity from 100% to 77.3%. Conclusion: Compared to urinary cytology, UBC tests alone as well as UBC tests in combination with bladder washing cytology revealed higher sensitivities in detecting low- and high-grade tumors, but at the expense of a lower specificity. Thus, currently cystoscopy cannot be replaced by any of the evaluated methods.

Comparative Evaluation of the Bladder Tumor-Associated Antigen, Urinary Bladder Cancer Antigen, Tissue Polypeptide Specific Antigen and Voided Urine Cytology in Early Detection of Primary Bladder Tumors

“…In contrast to its rather low sensitivity, cytology exhibited excellent specificity (96.87%), without statistically significant differences compared to the other tests (BTA: 89.79%; UBC: 86.73% and TPS: 54.08%). In line with our results, several reports [11,13,14,19,20] showed that compared to urine cytology, UBC alone revealed higher sensitivity in detecting low-grade bladder tumors and lower specificity. As for TPS, we have not found studies that analyze its diagnostic performance for prediction of NMIBC.…”

Development and Validation of a Novel Recurrence Risk Stratification for Initial Non-Muscle Invasive Bladder Cancer in the Han Chinese Population

“…However, there is no new consensus indicator on the risk factors for the recurrence of NMIBC, especially the lack of relevant tumor indicators in urine. Urine BLCA-4, BTA, NMP22, and CEA can be used as important markers for the diagnosis and recurrence monitoring of bladder cancer [23][24][25][26][27][28][29][30]. At present, the specificity and sensitivity of BLCA-4 detection for bladder cancer diagnosis have reached a high level.…”

“…NMP22 is mainly involved in DNA replication and transcription, RNA synthesis and gene expression regulation, and its content can be determined by detecting the amount of protein released by apoptotic cells [28]. Related studies have shown that NMP22 content is positively correlated with tumor size, stage, and grade [29]. CEA is a tumor-associated antigen.…”

Molecular biomarkers in diagnosis of bladder cancer

“…Недавно были опубликованы 4 исследования сравнения маркеров, в которых сообщается о низкой чувствительности (11-58 %) качественного теста в диагностике рецидива РМП [9,[10][11][12]. В связи с этим высказывается предположение о том, что этот тест может быть полезен при принятии решения о немедленной либо отсроченной цистоскопии в зависимости от индивидуальной схемы наблюдения [13].…”