The Use Of Urinary Nuclear Matrix Protein 22 (NMP22) Test,Abdominal Ultrasound And Cytology In Diagnosis Of Recurrent Bladder Cancer

Objective To evaluate the clinical significance of Nuclear Matrix Protein 22(NM P22)Test,the Abdominal Ultrasound and Cytology in diagnosis of recurrent bladder cancer.Methods A total of 60 patients with a history of bladder cancer were enrolled in this study.All the patients were performed abdominal ultrasound.Urine specimens,collected prior to a cystoscopic biopsy either from patients were studied for the NMP22 Test and the Cytology.The diagnosis,determined by the cystoscopic findings and biopsy findings of the suspicious lesion was considered as the gold standard.For positive biopsies,the results of the NMP22 Test,Cytology and the Abdominal Ultrasound were also correlated with tumour grade,stage and the risk of recurrence.Results In the 60 paitents,the mean age was 64.75(30-88)years old and 45 of them had positive biopsy findings.The overall sensitivity of the NMP22 Test was 68.9%,inferior to that of(82.2%,X~2=4.39,P<0.05))and the sensitivity of the Cytology was inferior to any of them(55.6%,X~2=5.99、4.54,P<0.05).The specifity of the Cytology was superior to that of the NMP22 Test and the Abdominal Ultrasound(86.7% vs 73.3%,33.3%).As for the negative predictive value,the NMP22 Test(44%)was superior to the Cytology(39.1%)and the Abdominal Ultrasound(38.5%).According to the golden standard,the sensitivity increased with increasing tumor stages for the NMP22 Test and the Cytology(X~2=17.81 和 16.41,P<0.05)except for the Abdominal Ultrasound(P>0.05).As for the sensitivity of different risk of recurrence,the sensitivity also increased with increasing risk for the NMP22 Test and the Cytology (X~2=9.254 、 13.62,P<0.05)except for the Abdominal Ultrasound(P>0.05).In the low-risk group,the sensitivity of the NMP22 Test was superior to that of the Cytology but no significant difference was found in the Abdominal Ultrasound and the NMP22 Test(or the Cytology).In the high-risk group,no significant difference was showed.Conclusion The NMP22 Test displayed higher sensitivity than the Cytology in detection of recurrent bladder cancer,especially in the low-risk of recurrence ones and the sensitivity increased significantly when combining the NMP22 Test the Cytology.The Abdominal Ultrasound showed higher sensitivity in detection of exophytic bladdercancer.Although it can’t replace the Cytology in the follow-up of bladder cancer due to its pool sensitivity in detection of Ta or Tis tumors,it could be an adjunctive for the NMP22 Test or the Cytology.