Comparisons of voided urine cytology, nuclear matrix protein-22 and bladder tumor associated antigen tests for bladder cancer of geriatric male patients in Taiwan

Ke-Hung Tsui¹¹, Shao-Ming Chen², Ta-Ming Wang³, Horng-Heng Juang⁴, Chien-Lun Chen³, Guang-Huan Sun⁵, Phei-Lang Chang<sup>3*

1</sup> Department of Nursing, Chang Gung Institute of Technology, Taoyuan 333, Taiwan, China
² Department of Urology, Taipei City Hospital, Heping Campus, Taipei, Taiwan, China
³ Chang Gung Bioinformatics Center, Department of Geriatric Urology, Chang Gung Memorial Hospital, Kwei-Shan, TaoYuan 333, Taiwan, China.
⁴ Department of Anatomy, Chang Gung University, College of Medicine, Taoyuan, Taiwan, China
⁵ Division of Urology, Department of Surgery, Tri-Service General Hospital, National Defense medical Center, Taiwan, China

DOI: 10.1111/j.1745-7262.2006.00218.x

Abstract
Aim: To compare the results of bladder tumor associated antigen (BTA TRAK) and nuclear matrix protein 22 (NMP 22) by using voided urine cytology. Methods: The 135 elderly male and 50 healthy volunteers enrolled in this study were classified into different groups: (i) patients with bladder cancer; (ii) patients with urinary benign conditions; and (iii) healthy volunteers. BTA TRAK and NMP 22 kits were used to detect bladder cancer. Voided urine cytology was used to compare the sensitivity and specificity of the screening tests. Results: The sensitivity and specificity of cytology were 23.5 and 96.9 %, respectively. The sensitivity and specificity of BTA TRAK were 50.98 and 73 %, respectively. The sensitivity and specificity of NMP 22 were 77.5 and 73.47 %, respectively. The test level of NMP 22 increases with tumor grading. The bladder tumor associated antigen kit has the lowest sensitivity among the screening tests. The NMP 22, which has the best sensitivity, can be an adjunct to cytology for evaluating bladder cancer. Conclusion: The NMP 22 test has a better correlation with the grading of the bladder cancer than BTA TRAK. As cytology units are typically not available in hospitals or in outpatient clinics, NMP 22 might be a promising tool for screening bladder cancer.

Keywords: bladder neoplasm; cytology; bladder tumor associated antigen; nuclear matrix protein 22

Correspondence to: Dr Phei-Lang Chang, MD, Department of Geriatric Urology, Chang Gung Memorial Hospital, 5 Fu-Shing Street, Kweishan, Taoyuan 333, Taiwan, China
Tel: +886-3-3281-200-2137, Fax: +886-3-3274-541
E-mail: khtsui@yahoo.com
Received 2006-04-18 ?Accepted 2006-06-05