Ali OZUDOGRU, Erdogan AGLAMİS, Gokhan TOKTAS, Cemal TASDEMİR, Cavit CEYLAN, Erdinc UNLUER

Yüzeyel mesane tümörlerinin takibinde sistoskopi ve üriner sitoloji ile NMP22'nin karşılaştırılması

Amaç: Mesane tümörü tespitinde NMP22 testini, sistoskopi ve sitoloji sonuçları ile birlikte değerlendirmek. NMP22 değerinin; intravezikal BCG uygulaması, tümör grade ve tümör stage ile ilişkisini karsılastırmak. Hastalar ve Metot: Mesane tümörü nedeniyle sistoskopi takibindeki toplam 78 hasta çalışmaya dahil edildi. Kontrol sistoskopisi yapılan hastaların idrarında NMP22 bakıldı. Mesane yıkantı suyundan sitoloji alındı. NMP22 testinin ve sitolojinin duyarlılığı, seçiciliği, PPD (Pozitif kestirim değeri), NPD (Negatif kestirim değeri) ve toplam tanı değeri hesaplandı. Bulgular: Hastaların ortalama yaşı 56 ± 8 idi. NMP22 'nin duyarlılığı %63,6, seçiciliği %95,4, PPD %70, NPD 93,3, Toplam tanı değeri %90,7 olarak bulunmuştur. NMP22 ve sitoloji karşılaştırıldığında duyarlılık NMP22'de yaklaşık 2 kat fazla bulunmuştur. Toplam tanı değeri bakımından ise aralarında anlamlı fark bulunamamıştır (p> 0,3). Stage ve NMP22 değerleri bakımından anlamlı fark bulunamamıştır (P > 0.4). Ancak grade arttıkca NMP22 değerleri anlamlı olarak artmaktadır (P=0,03). NMP22 sonuçları intrakaviter immünoterapiden etkilenmemiştir. Sonuç: NMP22 üriner sitolojiden daha duyarlı bulunmuştur. NMP22 intrakaviter immünoterapiden etkilenmemiştir. Tümör grade'i arttıkca NMP22 değerleri artmıştır. Ancak tümör stage ile anlamlı ilişki saptanmamıştır. NMP22 testi kontrol sistoskopisinin yerini almada yetersiz kalmaktadır. Ancak daha iyi bir tümör belirleyiciye sahip oluncaya kadar,NMP22 testi kullanılabilir. NMP22 testi negatif gelen hastalarda kontrol sistoskopi aralıkları, açılabilir.

Anahtar Kelimeler:

NMP22, mesane kanser, sistoskopi ve sitoloji

Comparison of Nuclear Matrix Protein (NMP22) test with cystoscopy and urine cytology in follow-up of patients with superficial bladder cancer

Abstract Abstract Purpose: To evaluate the clinical performance of Nuclear Matrix Protein (NMP22) test and to compare it with cystoscopy and urine cytology in follow-up of patients with superficial bladder cancer. We also investigated in relation of NMP22 value with intravesical BCG ( Bacillus Calmette Guerin) administration, tumor grade and tumor stage. Patients and Method: A total of 76 patients in cystoscopy follow-up due to superficial bladder cancer were included in the study. NMP22 was scanned in urines of patients whose control cystoscopy was made. Cytology was taken from bladder eluate. Sensitivity, specificity, PPD (Positive Predictive Value), NPD (Negative Predictive Value) and accuracy of NMP22 test were calculated. Results: The mean age of patients were 56 ± 8. Sensitivity of NMP22 was found %63.6, its specificity was %95.4 , PPD was %70 , NPD was 93.3 , accuracy was %90.7. When NMP22 and cytology were compared, sensitivity of NMP22 was found by approximately 2 times more. In terms of accuracy, no significant difference was found between them (p>0.3). In terms of stage and NMP22 values, no significant difference was found (P > 0.4). However, as long as grade increases, NMP22 values significantly increase (P=0.03). NMP22 results were not influenced by intracavitary immunotherapy. Conclusion: NMP22 was found more sensitive than urinary cytology. NMP22 were not influenced by intracavitary immunotherapy. As long as tumor grade increased, NMP22 values increased. But no significant relation with tumor stage was detected. The NMP22 test remains incapable for the supplanting of control cystoscopy. Until a better tumor marker was acquired, NMP22 test can be used. In patients with negative NMP22 test, control cystoscopy intervals may prolonged.

Keywords:

NMP 22 bladder cancer, cystoscopy, urine cytology,

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