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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Variability in the Performance of Nuclear Matrix Protein 22 for the Detection of Bladder Cancer
Journal of Urology, Volume 176, No. 3, Year 2006
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Description
Purpose: We assessed variability in the diagnostic performance of NMP22® for detecting recurrence and progression in patients with Ta, T1, and/or CIS transitional cell carcinoma of the bladder in a large international cohort. Materials and Methods: NMP22® voided urine levels were measured in 2,871 patients who underwent office cystoscopy for monitoring previous stage Ta, T1 and/or CIS transitional cell carcinoma at 12 participating institutions. Results: Patient characteristics varied considerably among institutions. Overall 1,045 patients (36.4%) had recurrent transitional cell carcinoma (range across institutions 13.6% to 54.3%). Median NMP22® was 5.5 U/ml (range across institutions 2.5 to 18.8). Of the patients 33.5% had grade III tumors (range across institutions 20.6% to 54.0%) and 22.4% had muscle invasive tumors (range across institutions 3.2% to 38.2%). Area under the ROC curve for bladder TCC detection was 0.735 (95% CI 0.715 to 0.755, range across institutions 0.676 to 0.889). The manufacturer recommended cutoff of 10 U/ml detected 57% of cases with a 19% false-positive rate. AUC for grade III and stage T2 or greater disease was 0.806 (95% CI 0.780 to 831) and 0.864 (95% CI 0.839 to 0.890), respectively. For each NMP22® cutoff NMP22® had higher sensitivity for detecting grade III and stage T2 or greater bladder transitional cell carcinoma than for detecting any cancer. No optimal cutoffs for detecting any or aggressive bladder transitional cell carcinoma could be derived based on NMP22® values. Conclusions: There is a substantial degree of heterogeneity in the diagnostic performance of NMP22® applied to populations from different institutions. There is no clearly defined NMP22® cutoff but there is a continuum of risk for recurrence and progression. © 2006 American Urological Association.
Authors & Co-Authors
Shariat, Shahrokh F.
United States, Dallas
Ut Southwestern Medical Center
Marberger, Michael Johann
Austria, Vienna
Universität Wien
Lotan, Yair R.
United States, Dallas
Ut Southwestern Medical Center
Sanchez-Carbayo, Marta
Spain, Salamanca
Hospital Clínico Universitario de Salamanca
Zippe, Craig
United States, Cleveland
Cleveland Clinic Foundation
Lüdecke, Gerson
Germany, Giessen
Justus-liebig-universität Gießen
Boman, Hans
Unknown Affiliation
Sawczuk, Ihor
United States, New York
Vagelos College of Physicians and Surgeons
Friedrich, Martin G.
Germany, Hamburg
Universität Hamburg
Casella, Roberto
Switzerland, Biel
Hospital Center Biel
Mian, Christine
Unknown Affiliation
Eissa, S.
Egypt, Cairo
Faculty of Medicine - Ain Shams University
Akaza, Hideyuki
Japan, Tsukuba
University of Tsukuba
Serretta, Vincenzo
Italy, Palermo
Università Degli Studi Di Palermo
Huland, Hartwig
Germany, Hamburg
Universität Hamburg
Hedelin, Hans
Unknown Affiliation
Raina, Rupesh
United States, Cleveland
Cleveland Clinic Foundation
Miyanaga, Naoto
Japan, Tsukuba
University of Tsukuba
Sagalowsky, Arthur I.
United States, Dallas
Ut Southwestern Medical Center
Roehrborn, C.
United States, Dallas
Ut Southwestern Medical Center
I. Karakiewicz, Pierre I.
Canada, Montreal
University of Montreal
Statistics
Citations: 111
Authors: 21
Affiliations: 12
Identifiers
Doi:
10.1016/j.juro.2006.04.017
ISSN:
00225347
Research Areas
Cancer
Genetics And Genomics
Health System And Policy
Study Design
Cohort Study