| Objective Study the changes of urine NMP22 test in patients with bladder cancer before and after operation,to investigate the application value of nuclear matrix protein 22(NMP22) for the diagnosis and prognosis of bladder cancer.Methods From February 2014 to Decembe 2015,A total of 104 Patients were prospectively enrolled in our study. urine NMP22 test were performed on the voided urine sample obtained before the cystoscopy and operation for all patients. For the patients of bladder cancer who had underwent partial cystectomy or transurethral resection of bladder tumor, the urine NMP22 test were performed again on the voided urine sample obtained after one week of surgical treatment,and completed at least 3 months of endoscopic and clinical follow-up for the patients. The recurrence rate of bladder retention was statistics after surgery, and discuss its relationship with the results of NMP22 detection and whether urine NMP22 detection can evaluate the prognostic of bladder cancer.Results A total of 104 patients, including 27 cases with benign disease and 77 cases with bladder cancer,and all patients with bladder cancer were diagnosed pathologically.In 27 cases benign patient,7 cases results of NMP22 test were position while 20 cases were negitive; In 77 bladder cancer patients,9 cases results of NMP22 test were negitive while 68 cases were positive,the sensitivities and specificities of the NMP22 test for detection of bladder cancer were 88.3%(68/77)and 74.1%(20/27).Among 77 TCC patients,39 cases had superficial cancer(Ta-T1) and 31 cases showed positive in the urinary NMP22 test while 8 cases were negitive; 38 cases had invasion cancer(T2-T4) and 37 cases showed positive in the urinary NMP22 test while 1 cases negitive; The sensitivity rate of two groups were 79.5%(31/39) and 97.4%(37/38),respectively(P =0.029), which was significantly diferent bettwen two groups. Among 77 TCC patients,51 cases had higher grade cancer and 49 cases showed positive in the urinary NMP22 test while 2 cases were negitive; 26 cases had lower grade and 19 cases showed positive in the urinary NMP22 test while 7 cases negitive; The sensitivity rate of two groups were 96.1%(49/51) and 73.1%(19/26),respectively(P =0.006), which was significantly diferent bettwen two groups.The NMP22 test were performed again ultimatel on a total of 56 patients who had underwent reserve bladder surgical,and 23 cases of NMP22 test were positive while 33 cases were negetive. 15 cases were diagnosed as recurrent bladder TCC.,10 case were positive of NMP22 test,and 5 case were negetive. The sensitivities and specificities of the NMP22 test for prediction of recurrent bladder cancer were 66.7%(10/15)? 68.3%(28/41), respectively,which was significantly diferent bettwen two groups(P<0.001). Among 56 TCC patients,the cases of superficial cancer(Ta-T1), invasion cancer(T2-T4),higher grade and lower grader patients were 30,26,34 and 22, respectively. Among the 34 cases higher grade cancer patients, 12 cases were recurrence patients with 9 cases showed positive in the urinary NMP22 test while 3 cases were negitive,and 22 cases were no-recurrence patients with 6 cases showed positive in the urinary NMP22 test while 16 cases were negitive, The sensitivity rate of two groups were 75.0%(9/12) and 27.3%(6/22),respectively, which was significantly diferent bettwen two groups(P =0.012). Among the 22 cases lower grade cancer patients, 3 cases were recurrence patients with 1 cases showed positive in the urinary NMP22 test while 2 cases were negitive,and 19 cases were no-recurrence patients with 7 cases showed positive in the urinary NMP22 test while 12 cases were negitive, The sensitivity rate of two groups were 33.3%(1/3) and 36.8%(7/19),respectively,which was significantly diferent bettwen two groups(p>0.05). Among the 30 cases superficial cancer(Ta-T1) patients, 7 cases were recurrence patients with 3 cases showed positive in the urinary NMP22 test while 4 cases were negitive,and 23 cases were no-recurrence patients with 7 cases showed positive in the urinary NMP22 test while 16 cases were negitive, The sensitivity rate of two groups were 42.9%(3/7) and 30.4%(7/23),respectively, which have no significantly diferent bettwen two groups(P>0.05). Among the 26 cases invision cancer(T2-T4) patients, 8 cases were recurrence patients with 7 cases showed positive in the urinary NMP22 test while 1 cases were negitive,and 18 cases were no-recurrence patients with 6 cases showed positive in the urinary NMP22 test while 12 cases were negitive, The sensitivity rate of two groups were 87.5%(7/8) and 33.3%(6/18),respectively, which was significantly diferent bettwen two groups(p=0.03). Demonstrate a high sensitivities and specificities of the NMP22 test for prediction of higher grade or invision cancer(T2-T4) bladder cancer recurrence, but its prediction performance is limited in lower grade or superficial cancer(Ta-T1) bladder cancer recurrence.Conclusions The urinary NMP22 test was a promising noninvasive diagnostic marker for urinary transitional cell carcinoma. The urinary NMP22 test also can use in prediction of the recurrence of transitional cell carcinoma of the bladder, especially for prediction of higher grade or invision cancer(T2-T4) bladder cancer recurrence, but its prediction performance is limited in lower grade or superficial cancer(Ta-T1) bladder cancer recurrence. |
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