This article is more than 5 years old. Information may no longer be current.
NMP22 test helps detect most recurring bladder cancers
Cystoscopy and NMP22 test combine for 99% bladder cancer detection rate.
A simple urine test can help detect the recurrence of bladder cancer and is more accurate than conventional laboratory tests.
Nuclear matrix protein 22 (NMP 22) (BladderChek, Matritech) used with a diagnostic scope detected 99% of recurring bladder cancers, according to a study that appeared in the Journal of the American Medical Association.
“This is good news for patients,” said researcher Barry Stein, MD, professor of urology at Brown Medical School and surgeon-in-chief of urology at Rhode Island Hospital, in a press release. “If you have been treated for bladder cancer and are being monitored for recurrence, the accuracy of your diagnosis is extremely important.”
The test detects elevated levels of NMP22, which indicates cancer at early stages of the disease. A physician or nurse can interpret the results in 30 to 50 minutes.
“NMP22 is one of the first tumor-associated markers discovered by protein analysis technology rather than immunoreactivity and hence could represent a ‘first in class’ tumor marker,” said Donald L. Trump, MD, FACP, from Hem/Onc Today’s editorial board. “This study indicates that NMP22 is superior to urine cytology in assessing of individuals who have had bladder cancer. Urine cytology, when positive, is more specific but the high frequency of false-negative urine cytology exams in this multisite study indicates that NMP22 may well replace the use of routine cytology as a monitoring tool. However, this study does not address the use of NMP22 in any situation other than the follow-up of treated bladder cancer. Screening for bladder cancer in patients at risk for the development of bladder cancer, but in whom diagnosis has not previously been made were not studied by this group.”
In this study, 668 patients with a history of bladder cancer provided a urine sample before undergoing cystoscopy during follow-up visits with their physician. Physicians analyzed each sample with urine cytology, and with the NMP22 test. The tests identified bladder cancer in 103 patients. Cystoscopy alone detected 94 cancers. The NMP22 test detected eight of the nine cancers that physicians could not see through the scope. Seven of the cancers detected only with the NMP22 test were life threatening, according to the researchers. Urine cytology detected three of the nine cancers.
Cystoscopy alone detected 91.3% of cancers. When physicians paired cystoscopy with conventional urine analysis, the detection rate was 94.2%. When they paired cystoscopy with the NMP22 test, the detection rate was 99%.
An accurate urine test could reduce the number of cystoscopies a patient has to undergo, Stein said. Although it is not necessarily painful, the procedure can be uncomfortable. By contrast, the NMP22 test is administered similar to a pregnancy test and gives objective results. When the tests detect cancer, a purple line appears.
For more information:
- Grossman HB, Soloway M, Messing M, et al. Surveillance for recurrent bladder cancer using a point-of-care proteomic assay. JAMA. 2006;295:299-305.