膀胱癌診断におけるスクリーニング法の検討 : Nuclear matrix protein-22, Bladder tumor antigenならびに尿細胞診の比較

Abstract

今回の検討にて, 新しい膀胱癌の尿中マーカーであるNMP-22及びBTAの有用性が示された.MNP-22は診断前スクリーニングに優れているのに対して, BTAは治療後経過観察に優れている.膀胱鏡検査にこれらの検査と尿細胞診を組み合わせることにより, 非侵襲的に膀胱癌の診断率が高まることが期待される

We evaluated the utility of urinary parameters (Nuclear Matrix Protein-22: NMP-22, Bladder Tumor Antigen: BTA, and cytological examinations) for the diagnosis or post-therapeutic monitoring of bladder cancer. Thirty one tumor-bearing cases including 19 fresh cases and 40 tumor-free cases, were subjects of this study. Using identical voided urine samples, NMP-22, BTA and urinary cytology were examined. The mean values of NMP-22 (cut-off value is 12 U/ml) was 100.5 +/- 26.5 U/ml in the tumor-bearing group and 21.9 +/- 7.8 U/ml in the tumor-free group (p < 0.05): Sensitivity was 74.2%, and specificity was 67.5%. Sensitivity of BTA was 58.1%, and specificity was 97.5%. Only five cases were judged positive by urinary cytology: 16.1% in sensitivity and 100% in specificity. Thus, NMP-22 and BTA were more sensitive than urinary cytology. In conclusion, the new urinary parameters, NMP-22 and BTA, would be less invasive and useful as tumor markers of bladder cancer. NMP-22 seems suitable for screening before the diagnosis and BTA for the post-therapeutic follow-up study.