Volume 12 Supplement 1

11th Annual Conference of the International Society for the Prevention of Tobacco Induced Diseases (ISPTID)

Open Access

Screening for urinary bladder cancer with the use of nuclear matrix protein (NMP) 22: is it feasible?

  • Anastasios Stefanopoulos1, 2Email author and
  • Konstantinos P Economopoulos2, 3
Tobacco Induced Diseases201412(Suppl 1):A6

https://doi.org/10.1186/1617-9625-12-S1-A6

Published: 6 June 2014

Background

Tobacco use accounts for the majority of urinary bladder cancer (UBC) cases both in men and women. It is widely accepted that smokers have increased risk of UBC [14]. An early diagnosis of UBC is crucial because patients with superficial UBC have much better prognosis than those with invasive UBC [1, 2, 4, 5]. During the past years a variety of urine based markers have been introduced for screening of UBC. Nuclear matrix protein 22 (NMP22) is a nuclear protein that is accountable for chromatid regulation and cell separation during replication. The detection of NMP22 has been used from many clinical studies to evaluate the possibility of UBC screening [2, 68]. The purpose of this review is to access the current literature in order to determine the usefulness of NMP22 in screening of UBC.

Materials and methods

A thorough search was conducted in MEDLINE using the terms urinary bladder cancer OR urinary bladder neoplasm, NMP22 and screening. The following inclusion criteria were adopted: i. studies that NMP22 was measured in high risk patients without UBC and ii. studies that NMP22 was compared between patients with known history of UBC and a control group without history of UBC. We excluded studies that NMP22 was used only for the surveillance of UBC.

Results

185 English-language articles were retrieved and 38 were included in this study. Average total sensitivity of NMP22 was 73.44 ± 15.11% and average total specificity 72.82 ± 16.27%. Positive predictive value (PPV) was 37.12 ± 26.11% and negative predictive value (NPV) was 87.47 ± 10.60%. Two studies did not report total specificity or sensitivity rates. The majority of the reports concluded than NMP22 cannot be used for screening non-invasive UBC but benefits the screening for high grade UBC in symptomatic patients. However there is no study in the literature that indicates that NMP22 detection approaches level 1 of evidence in screening for UBC. Based on the fact that the prevalence of UBC in asymptomatic high risk patients without history of UBC is low (4.0%), the diagnostic value of mass screening programs in asymptomatic patients is questionable.

Conclusions

Detection of NMP22 is a non-invasive test that can be easily applied and gives diagnostic answers very quickly especially for tobacco-induced high grade tumors. NMP22 detection cannot replace cystoscopy. It is essential, more studies to be conducted with careful selection of patients, in order to find out, if NMP22 or a combination with other markers are useful for diagnosing UBC [1, 2, 5].

Authors’ Affiliations

(1)
Medical school, National and Kapodistrian University of Athens
(2)
Society of Junior Doctors
(3)
Massachusetts General Hospital, Harvard Medical School

References

  1. Roobol MJ, Bangma CH, el Bouazzaoui S, Franken-Raab CG, Zwarthoff EC: Feasibility study of screening for bladder cancer with urinary molecular markers (the BLU-P project). UrolOncol. 2010, 28 (6): 686-90.Google Scholar
  2. Grossman H, Messing E, Soloway M, Tomera K, Katz G, Berger Y, Shen Y: Detection of Bladder Cancer Using a Point-of-Care Proteomic Assay. JAMA. 2005, 293 (7): 810-816. 10.1001/jama.293.7.810.View ArticlePubMedGoogle Scholar
  3. Huber S, Schwentner C, Taeger D, Pesch B, Nasterlack M, Leng G, Mayer T, Gawrych K, Bonberg N, Pelster M, Johnen G, Bontrup H, Wellhäusser H, Bierfreund HG, Wiens C, Bayer C, Eberle F, Scheuermann B, Kluckert M, Feil G, Brüning T, Stenzl A, UroScreen Study Group: Nuclear matrix protein-22: a prospective evaluation in a population at risk for bladder cancer. Results from the UroScreenstudy. BJU Int. 2012, 110 (5): 699-708. 10.1111/j.1464-410X.2011.10883.x.View ArticlePubMedGoogle Scholar
  4. Lotan Y, Capitanio U, Shariat SF, Hutterer GC, Karakiewicz PI: Impact of clinical factors, including a point-of-care nuclear matrix protein-22 assay and cytology, on bladder cancer detection. BJU Int. 2009, 103 (10): 1368-74. 10.1111/j.1464-410X.2009.08360.x.View ArticlePubMedGoogle Scholar
  5. Lotan Y, Elias K, Svatek RS, Bagrodia A, Nuss G, Moran B, Sagalowsky AI: Bladder cancer screening in a high risk asymptomatic population using a point of care urine based protein tumor marker. J Urol. 2009, 182 (1): 52-7. 10.1016/j.juro.2009.02.142.View ArticlePubMedGoogle Scholar
  6. Ramakumar S, Bhuiyan J, Besse JA, Roberts SG, Wollan PC, Blute ML, O'Kane DJ: Comparison of screening methods in the detection of bladder cancer. J Urol. 1999, 161 (2): 388-94. 10.1016/S0022-5347(01)61899-8.View ArticlePubMedGoogle Scholar
  7. Moonen PM, Kiemeney LA, Witjes JA: Urinary NMP22 BladderChek test in the diagnosis of superficial bladder cancer. EurUrol. 2005, 48 (6): 951-6.Google Scholar
  8. Shariat SF, Marberger MJ, Lotan Y, Sanchez-Carbayo M, Zippe C, Lüdecke G, Boman H, Sawczuk I, Friedrich MG, Casella R, Mian C, Eissa S, Akaza H, Serretta V, Huland H, Hedelin H, Raina R, Miyanaga N, Sagalowsky AI, Roehrborn CG, Karakiewicz PI: Variability in the performance of nuclear matrix protein 22 for the detection of bladder cancer. J Urol. 2006, 176 (3): 919-26. 10.1016/j.juro.2006.04.017.View ArticlePubMedGoogle Scholar

Copyright

© Stefanopoulos and Economopoulos; licensee BioMed Central Ltd. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Advertisement