膀胱癌検出における尿中NMP22(Nuclear Matrix Protein22)Bladder Chekの臨床的有用性の検討

Abstract

血尿患者および膀胱癌患者各40例を対象に尿中NMP22 Bladder Chekの臨床的有用性について検討した.その結果, 1)膀胱癌に対するNMP22 Bladder Chekの陽性率は62.5%で, 従来のNMP22 ELISAの55%と有意差を認めず, 尿細胞診の27.5%より高値を示した.2)膀胱癌におけるパラメーターの検討では, NMP22 ELISAで初発例, 異型度, 深達度, 大きさがいずれも悪化すると陽性率は上昇傾向を示し, NMP22 Bladder Chekにおいても同様の結果であった.3)血尿患者では偽陽性を5例で認められ, 3例は尿路結石, 1例は慢性腎炎, 1例は尿道カルンクルであり, NMP22 Bladder ChekとNMP22 ELISAの一致率は95%であった

The clinical usefulness of the nuclear matrix protein 22 (NMP22) Bladder Chek test as a novel urine marker in the detection of patients with bladder cancer was evaluated in comparison with the urinary NMP22 enzyme-linked immunosorbent assay (ELISA) and urinary cytology. A total of 40 patients with pathologically proven bladder cancer voided urine specimen before treatment. The urine samples were divided for NMP22 Bladder Chek test, NMP22 ELISA, and urinary cytology. In the 40 patients with bladder cancer, the overall positive rate was 62.5% for the NMP22 Bladder Chek test, 55% for the NMP22 ELISA test, and 27.5% for urine cytology. There was a significant difference between NMP22 Bladder Chek, NMP22 ELISA and cytology. The positive rate with the NMP22 Bladder Chek and NMP22 ELISA was higher in the patients with high grade and large-size (1 cm < or =) tumor. In 40 patients presenting with microhematuria without urothelial cancer, the false positive rate 12.5, 10, and 0% for NMP22 Bladder Chek, NMP22 ELISA, and urinary cytology. No significant difference was found with the test. In conclusion, the urine NMP22 Bladder Chek test provided a higher positive rate than the NMP22 ELISA test and urinary cytology. Therefore, the NMP22 Bladder Chek test may be clinically more useful as a tumor marker for the diagnosis of bladder cancer.