Can use the NMP22 BladderChek Decrease the Frequency of Cystoscopy in the Follow up of Patients with Bladder Carcinoma ?

Background and Aim: Bladder cancer is one of the most common cancers. Its diagnosis,management and follow up represent a burden in urology practice. "NMP22 BladderChek" is a urine test that measures levels of NMP22 (nuclear matrix protein 22), which is a protein found in both normal and cancerous cells of the bladder. However, levels of NMP22 are usually elevated in the presence of bladder cancer. To assess the accuracy of urinary NMP22 qualitative assay for the detection of recurrence of transitional cell carcinoma (TCC) during follow up period compared to the radiological investigations, urine cytology and check cystoscopy; and if it can be relied upon for the follow up to decrease the frequency of check cystoscopy.

Methods: 38 patients known to have bladder cancer, undergoing surveillance, were subjected to abdominal- pelvic ultrasonography, NMP22 BladderChek test; urine cytology followed by check cystoscopy and biopsy if indicated. The accuracy of these tools was compared by their sensitivity and specificity as well as diagnostic likelihood ratio in detecting recurrence of bladder cancer.

Results: The sensitivity and positive likelihood ratio of NMP22 BladderChek were superior to urine cytology (95% and 8.5 vs 50% and 4.5, respectively), while both diagnostic modalities were equal in terms of specificity (88.9%).

Conclusions: NMP22 BladderChek is a simple in-office test which proved in the current study to be highly sensitive in detecting recurrence, it can change the classical regimen for follow up of bladder cancer cases; reducing the number of check cystoscopies  for these patients.