The efficacy and the safety of the NMP22 test in the follow-up of urinary bladder transitional cell carcinoma after transurethral resection

  • Levent Sağnak
  • Hamit Ersoy
  • Ahmet Kiper
  • Selçuk Esengen
  • Hikmet Topaloğlu

Received Date: 15.11.2006 Accepted Date: 19.01.2007 Gulhane Med J 2007;49(1):14-20

This study has been prepared to evaluate the efficacy of NMP22 test in the followup of recurrent bladder transitional cell carcinoma and to compare it with urine cytology used to assist to cystoscopy. Urine samples voided prior to cystoscopic examination were collected from 94 patients who were in the follow-up program for superficial bladder cancer, and stabilized in the NMP22 urine collection kit. During the cystoscopic examination, the bladder cleaning sample for cytologic examination was taken by irrigating the bladder, and it was stabilized by the ethyl alcohol until cytopathologic analysis. Urines of those who had recurrent tumors had significantly higher NMP22 levels than those of those who did not have recurrent tumors (p<0.001). When reference value of 10 U/ml was used in NMP22 test, the sensitivity, specificity, positive predictive value and negative predictive value were 73.8%, 82.7%, 77.5% and 79.6%, respectively. The sensitivity and specificity of urine cytology were 52.4% and 90.4%, respectively. The sensitivity of NMP22 test was significantly higher than that of urine cytology in tumors with low grade and stage. Although the sensitivity and negative predictive value of NMP22 test were significantly higher than those of urine cytology in bladder transitional cell carcinomas, especially with low grade and stage, it should be evaluated as a complemantary test to cytology rather than taking place of it as an assistant method to cystoscopy since it does not have sufficient specificity.

Keywords: Urinary bladder tumors, NMP22, transurethral resection