Nuclear matrix protein-22: a prospective evaluation in a population at risk for bladder cancer. Results from the UroScreen study
Nuclear matrix protein-22: a prospective evaluation in a population at risk for bladder cancer. Results from the UroScreen study
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DOI：
10.1111/j.1464-410x.2011.10883.x
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发表时间：
2012-09-01
影响因子：
4.5
通讯作者：
Stenzl, Arnulf
中科院分区：
文献类型：
--
作者：
Huber, Severine;Schwentner, Christian;Stenzl, Arnulf
目的评价核基质蛋白-22(NMP22)在高危人群膀胱癌筛查中的价值及其对变量的影响。研究对象为1772名接触致癌芳香胺的化学工作者，平均年龄62岁。总共进行了1609人的7091次筛查。采集尿样进行NMP22免疫定量分析、尿液分析和肌酐浓度评估。可疑病例行膀胱镜检查和电切。结果组织病理学分析发现3例低度恶性膀胱癌、5例复发膀胱癌和13例原发膀胱癌。224例患者血清NMP22浓度升高(>；10U/mL)，其中6例能准确预测BC(敏感性97.29%，特异性28.57%；阴性预测值99.04%，阳性预测值12.24%)。大量血尿影响NMP22检测结果[优势比(OR)3.49，95%可信区间[CI]1.81~6.73]。感染也会影响NMP22的检测结果(OR4.13，95%CI 2.31~7.35)。尿中NMP22的阳性率与肌酐浓度<2.5g/L有关(OR1.61，95%CI 0.91~2.86)。结论血尿、感染和尿浓缩对NMP22的检测结果有影响。NMP22不能单独用于高危人群的初筛，也不能作为膀胱镜检查的辅助手段。
OBJECTIVETo evaluate the value of nuclear matrix protein-22 (NMP22) in bladder cancer (BC) screening, and its effect on variables in a prospective study in a high-risk population.PATIENTS AND METHODSA total of 1772 chemical workers (mean age 62 years) exposed to carcinogenic aromatic amines were enrolled in the study.In all, 7091 screening check-ups in 1609 subjects were performed.Urine samples were collected for a quantitative NMP22 immunoassay, urine analysis and creatinine concentration assessment.Cystoscopy and subsequent transurethral resection were performed where there were suspicious findings.RESULTSHistopathological analysis found three papillary urothelial neoplasms of low malignant potential, five recurrent BCs and 13 primary BCs. Three tumours were at a muscle-invasive stage (pT2, pT3a or pT3b).We found higher NMP22 concentrations (> 10 U/mL) in 224 patients, which correctly predicted BC in six cases (sensitivity 97.29%, specificity 28.57%; negative predictive value 99.04%, positive predictive value 12.24%).Gross haematuria affected NMP22 results (odd ratio [OR] 3.49, 95% confidence interval [CI] 1.81-6.73). Infection also affected NMP22 results (OR 4.13, 95% CI 2.31-7.35).NMP22 was more frequently positive in urine with creatinine concentration > 2.5 g/L (OR 1.61, 95% CI 0.91-2.86).CONCLUSIONSNMP22 outcomes are affected by haematuria, infection and concentrated urine.NMP22 alone cannot be recommended for primary screening in a high-risk population nor as an alternative to cystoscopy during follow-up.A NMP22 test might be a useful adjunct to urine cytology.