The Application Of NMP22 Combined With Liquid Based Cytology In The Diagnosis Of Bladder Cancer

Backgroud: Bladder cancer is the most common malignancy of the urinary tract, according to statistics,every year about 386300 new cases were diagnosed with bladder cancer, and the number of annual global died of bladder cancer reaches more than 150200. In recent years, the incidence and mortality increased year by year. Bladder urothelial carcinoma of bladder cancer accounted for more than 90%, of which more than 70% fornon muscle invasive bladder cancer, tumor resection 5 years recurrence rate of 30%-80%. Multiple and high recurrence rate were the main clinical features. Therefore, early diagnosis, early treatment and prevention of recurrence is especially important. At present,cystoscopy is the gold standard for the diagnosis and monitoring of bladder cancer. But because of the invasive cystoscopy, for early tumor diagnosis is difficult and expensive to make the limited role of monitoring diagnosis and treatment of early bladder cancer.Therefore, the need to monitor more accurate methods of new research. In recent years,with the development of cytology and proteomics, research on tumor markers increasingly mature. In the clinical America food and Drug Administration(FDA) has been approved by the BTA Stat, BTA Trak, NMP22, FDP, Immuno Cyt and FISH six kinds of tumor markers for the diagnosis and monitoring of bladder cancer. Nuclear matrix protein 22(NMP22) is a nuclear matrix protein, and DNA on the regulation of RNA synthesis and replication,transcription, gene expression. The study found that the concentration of NMP22 in urine of patients with bladder cancer were significantly higher than that of normal people,therefore, NMP22 is considered to be a good marker of urothelial tumors, but its sensitivityis high, the specificity is low; urine cytology is currently used noninvasive widely, its high specificity(85~100%), but poor sensitivity(13~70%). With the development of cytologydetection technology, using BD Sure Path centrifugal sedimentation technology and new PAT’S(Thin Prep TCT) of liquid based cytology test mode as the representative of thealready mature application in gynecological cytologic detection field, in the field of gynecology application has not yet widely spread, but our department of a large number of pre clinical tests show that, the sensitivity of liquid based cytology check the detection of urothelial bladder cancer than conventional cytology has improved significantly.Objective:NMP22 in the urine of bladder cancer diagnosis sensitivity of 84.9%, specificity of 76.9%;This study focused on NMP22 combined with liquid based cytology in the clinical value of early diagnosis, postoperative follow-up of bladder cancer.Methods : From 2013 November to 2015 February, a total of 138 cases of suspected bladder urothelial cancer cases were included in the study. Each patient underwent NMP22, liquid based cytology. By cystoscopic biopsy or postoperative pathologic examination as the gold standard. NMP22 combined with liquid based cytology, both have a positive or positive diagnosis, both were negative when negative.Results: The urine NMP22 on the sensitivity of 84.9% specificity in the diagnosis of bladder carcinoma, 76.9%; cytology sensitivity 56.9%, specificity 96.2%. NMP22 combined withliquid based cytology, the sensitivity was 94.2%, specificity was 98.1%.Conclusion: NMP22 combined with liquid based cytology has high sensitivity and specificity, the sensitivity is much higher than that of the single index detection, the specificity is far higher than the NMP22 detection, and a little different from the liquid based cytology. Compared with the single index detection has higher diagnostic value for bladder cancer.