尿路移行上皮癌検出における尿中Nuclear matrix protein 22(NMP22)の有用性についての検討

Abstract

尿中nuclear matrix protein22(NMP22)測定値は非尿路上皮癌患者と比較し有意に尿路移行上皮癌患者で高値であった.尿中NMP22の尿路移行上皮癌検出感度は尿細胞診に比べ良好であったが有意差は認められなかった.特異度は尿細胞診が尿中NMP22に比べて有意に良好であった.尿中NMP22の偽陽性は腸管利用代用膀胱患者, 他癌膀胱浸潤, 尿路感染症, 尿路結石の順に多く認められた

We evaluated the usefulness of urinary nuclear matrix protein 22 (NMP22) compared to urinary cytology in the detection of urothelial transitional cell carcinoma (TCC). Between July 1999 and March 2000, 227 patients complaining of microscopic or gross hematuria were analyzed. Twenty-four patients (10.6%) had urothelial TCC. The urinary NMP22 level was significantly higher in the patients with urinary TCC compared to the other patients. The sensitivity and specificity of the results obtained with urinary NMP22 were 58.3% and 84.2%, respectively, and those obtained by urinary cytology were 45.8% and 98.0%, respectively. False-positive results were obtained with urinary NMP22 in the patients with urinary diversion using intestine, bladder invasion from other cancers, urinary tract infection, and urolithiasis. The urinary NMP22 level was significantly associated with tumor stage, suggesting its usefulness for detection of urothelial TCC. However, although urinary NMP22 showed equal sensitivity for the detection of TCC, it was not superior to urinary cytology.