• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>The Internet Journal of Urology >The Use of NMP22 and Urine Cytology for the Surveilance of Patients with Superficial Bladder Cancer
【24h】

The Use of NMP22 and Urine Cytology for the Surveilance of Patients with Superficial Bladder Cancer

机译：NMP22和尿液细胞学检查在浅表性膀胱癌患者中的应用

获取原文
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Aim To see if NMP22 combined with urine cytology can safely increase the interval between cystoscopies in the surveillance of superficial bladder cancers. Methods Thirty four patients with low grade superficial bladder transitional cell carcinomas were prospectively recruited and followed up with regular flexible cystoscopies over 2 years. Freshly voided urine was collected for urine cytology and NMP22 test prior to cystoscopy. Patients with suspicious cystoscopy findings or suspicious cytology underwent biopsies and/or resection of the suspicious lesions. Results 172 urine samples were collected and analyzed. The NMP 22 results were compared with voided urine cytology, cystoscopy and histological findings. Using the 10U/ml cutoff for quantitative measurement, the sensitivity, specificity, positive and negative predictive values of urinary NMP22 were 50%, 90.7%, 21.0%, and 97.3% respectively. When combined with voided urine cytology, the sensitivity, specificity, positive and negative predictive values were 71.4%, 88.5%, 25.0%, and 98.3% respectively. In comparison, the sensitivity, specificity, positive and negative predictive value of cystoscopy were 85.7%, 97.6%, 66.7%, and 99.2% respectively. Analysis with a receiver operating characteristic(ROC) curve found the ideal threshold of determinance of NMP22 for the detection of recurrences is 8.5U/ml with 100% sensitivity and 73.9% specificity. In our center, replacing alternate cystoscopy examination at 3,9,18 and 30 months with NMP22, results in a cost saving USD$740 or 37% per patient over 5 years. In the event of false positives, the patient will revert to the current surveillance schedule, with no increased costs incurred. Conclusion We propose that the optimal cutoff value for NMP22 is 8.5U/ml. At this level. the combination of the NMP22 BladderChek test and voided urine cytology is a sensitive non-invasive alternative to cystoscopy in the surveillance of patients who have had superficial low grade bladder cancer. Introduction Bladder cancer is the eleventh most common cancer in the world.[1] In Singapore, the age standardized incidence rate is 7.7/100,000 males, and 1.8/100,000 females per year.[2]Approximately 70% will present with superficial disease, and may be managed with transurethral resection with or without adjuvant intravesical therapy. The recurrence rates for bladder cancer are as high as 50% -70%, with as many as 10-15% progressing to muscle invasive disease.[3] Early diagnosis and treatment of bladder recurrences may permit bladder preservation, prevent progression and may improve survival.The high incidence and protracted natural history of bladder cancer results in a high prevalence of this disease. The need for frequent cystoscopic surveillance leads to high cost. In recent years, much research has been directed to finding tumour markers to aid in the screening, diagnosis and surveillance of bladder cancer. Candidate markers have included Nuclear Matrix protein (NMP22), Telomerase, Bladder Tumour Antigen (BTA), BCLA-4, Fibrin Degradation Products (FDP). Konety and Getzenberg [4] have summarised the sensitivities and specificities of these tests in their review of urine based markers of bladder cancer. (Table 1)
机译：目的探讨NMP22结合尿液细胞学检查是否可以安全地增加膀胱镜检查之间的膀胱镜检查间隔。方法前瞻性招募34例低度浅表浅表膀胱移行细胞癌患者，并在2年内定期进行定期的柔性膀胱镜检查。膀胱镜检查前，收集新鲜排泄的尿液用于尿液细胞学检查和NMP22测试。有可疑膀胱镜检查发现或可疑细胞学检查的患者接受活检和/或切除可疑病变。结果收集并分析了172份尿液样本。将NMP 22结果与尿液细胞学检查，膀胱镜检查和组织学结果进行比较。使用10U / ml截止值进行定量测量，尿NMP22的敏感性，特异性，阳性和阴性预测值分别为50％，90.7％，21.0％和97.3％。当与排尿尿细胞学检查结合时，敏感性，特异性，阳性和阴性预测值分别为71.4％，88.5％，25.0％和98.3％。相比之下，膀胱镜检查的敏感性，特异性，阳性和阴性预测值分别为85.7％，97.6％，66.7％和99.2％。用接收器工作特性曲线分析发现用于检测复发的理想NMP22测定阈值为8.5U / ml，灵敏度为100％，特异性为73.9％。在我们中心，用NMP22替代在3、9、18和30个月进行的另一次膀胱镜检查，可在5年内节省每位患者740美元或37％的成本。如果出现假阳性，患者将恢复到当前的监视时间表，而不会增加费用。结论我们建议NMP22的最佳临界值为8.5U / ml。在这个水平上。 NMP22 BladderChek测试与无效尿细胞学检查相结合是膀胱镜检查的一种敏感的非侵入性替代方法，可用于监测患有浅表低度膀胱癌的患者。引言膀胱癌是世界上第十一种最常见的癌症。[1]在新加坡，年龄标准化的发病率是每年7.7 / 100,000男性，和1.8 / 100,000女性。[2]约70％的患者会出现浅表疾病，可以通过经尿道切除术进行辅助或不辅助膀胱内治疗。膀胱癌的复发率高达50％-70％，其中有10-15％会发展为肌肉浸润性疾病。[3]膀胱癌的早期诊断和治疗可以保留膀胱，防止肿瘤进展并提高生存率。膀胱癌的高发病率和自然病程长导致这种疾病的高发。频繁的膀胱镜检查的需要导致高成本。近年来，许多研究已针对寻找肿瘤标记物以辅助膀胱癌的筛查，诊断和监测。候选标记包括核基质蛋白（NMP22），端粒酶，膀胱肿瘤抗原（BTA），BCLA-4，纤维蛋白降解产物（FDP）。 Konety和Getzenberg [4]在他们对基于尿液的膀胱癌标记物的综述中总结了这些测试的敏感性和特异性。 （表格1）

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号