Comparative Sensitivity of Urinary Cyfra 21-1, Urinary Bladder Cancer Antigen, Tissue Polypeptide Antigen and NMP22 to Detect Bladder Cancer

Reviewers: Li Liu, MD
Source: bladder cancer antigen, and tissue polypeptide antigen) and 1 nuclear matrix assay (NMP22) for the diagnosis of bladder cancer.

Method

A total of 111 patients with active bladder cancer, 76 patients with a history of bladder cancer and no evidence of active disease at the time of the study, and 80 symptomatic and asymptomatic controls comprised of healthy patients and patients with other urologic diseases and nonbladder malignancies were studied. All assays were performed an all patients, and compared for specificity and sensitivity.

Results

• Using cutoff values that yielded 95% specificity, the sensitivity for NMP22 was 75.7%, for CYFRA 21-1 was 83.8%, for urinary bladder cancer antigen was 73.9%, and 80.2% for tissue polypeptide antigen.
• False-positive rates for bladder cancer antigen and tissue polypeptide antigen were 20% and 36%, respectively for benign urologic conditions and 40% and 52%, respectively for nonbladder malignancies.
• NMP22 levels were statistically significant in detecting the depth of muscle invasion, undifferentiated tumors, larger tumors and multiple tumors.

Discussion

Cytokeratin assays and nuclear matrix assay used in this study may be potential noninvasive adjuncts to help determine the need for cystoscopy. The combination of more than one tumor marker may improve sensitivity of the tests. More studies with larger sample size are needed to assess the diagnostic role of these markers.