Detection of bladder cancer using a point-of-care proteomic assay

H. Barton Grossman, Edward Messing, Mark Soloway, Kevin Tomera, Giora Katz, Yitzhak Berger, Yu Shen

Research output: Contribution to journalArticle

269 Citations (Scopus)

Abstract

Context: A combination of methods is used for diagnosis of bladder cancer because no single procedure detects all malignancies. Urine tests are frequently part of an evaluation, but have either been nonspecific for cancer or required specialized analysis at a laboratory. Objective: To investigate whether a point-of-care proteomic test that measures the nuclear matrix protein NMP22 in voided urine could enhance detection of malignancy in patients with risk factors or symptoms of bladder cancer. Design, Setting, and Patients: Twenty-three academic, private practice, and veterans' facilities in 10 states prospectively enrolled consecutive patients from September 2001 to May 2002. Participants included 1331 patients at elevated risk for bladder cancer due to factors such as history of smoking or symptoms including hematuria and dysuria. Patients at risk for malignancy of the urinary tract provided a voided urine sample for analysis of NMP22 protein and cytology prior to cystoscopy. Main Outcome Measures: The diagnosis of bladder cancer, based on cystoscopy with biopsy, was accepted as the reference standard. The performance of the NMP22 test was compared with voided urine cytology as an aid to cancer detection. Testing for the NMP22 tumor marker was conducted in a blinded manner. Results: Bladder cancer was diagnosed in 79 patients. The NMP22 assay was positive in 44 of 79 patients with cancer (sensitivity, 55.7%; 95% confidence interval [CI], 44.1%-66.7%), whereas cytology test results were positive in 12 of 76 patients (sensitivity, 15.8%; 95% CI, 7.6%-24.0%). The specificity of the NMP22 assay was 85.7% (95% CI, 83.8%-87.6%) compared with 99.2% (95% CI, 98.7%-99.7%) for cytology. The proteomic marker detected 4 cancers that were not visualized during initial endoscopy, including 3 that were muscle invasive and 1 carcinoma in situ. Conclusion: The noninvasive point-of-care assay for elevated urinary NMP22 protein can increase the accuracy of cystoscopy, with test results available during the patient visit.

Original languageEnglish
Pages (from-to)810-816
Number of pages7
JournalJournal of the American Medical Association
Volume293
Issue number7
DOIs
StatePublished - Feb 16 2005
Externally publishedYes

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Point-of-Care Systems
Urinary Bladder Neoplasms
Proteomics
Cystoscopy
Cell Biology
Neoplasms
Urine
Confidence Intervals
Nuclear Matrix-Associated Proteins
Dysuria
Private Practice
Carcinoma in Situ
Veterans
Hematuria
Tumor Biomarkers
nuclear matrix protein 22
Urinary Tract
Endoscopy
Proteins
Smoking

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Grossman, H. B., Messing, E., Soloway, M., Tomera, K., Katz, G., Berger, Y., & Shen, Y. (2005). Detection of bladder cancer using a point-of-care proteomic assay. Journal of the American Medical Association, 293(7), 810-816. https://doi.org/10.1001/jama.293.7.810

Detection of bladder cancer using a point-of-care proteomic assay. / Grossman, H. Barton; Messing, Edward; Soloway, Mark; Tomera, Kevin; Katz, Giora; Berger, Yitzhak; Shen, Yu.

In: Journal of the American Medical Association, Vol. 293, No. 7, 16.02.2005, p. 810-816.

Research output: Contribution to journalArticle

Grossman, HB, Messing, E, Soloway, M, Tomera, K, Katz, G, Berger, Y & Shen, Y 2005, 'Detection of bladder cancer using a point-of-care proteomic assay', Journal of the American Medical Association, vol. 293, no. 7, pp. 810-816. https://doi.org/10.1001/jama.293.7.810
Grossman HB, Messing E, Soloway M, Tomera K, Katz G, Berger Y et al. Detection of bladder cancer using a point-of-care proteomic assay. Journal of the American Medical Association. 2005 Feb 16;293(7):810-816. https://doi.org/10.1001/jama.293.7.810
Grossman, H. Barton ; Messing, Edward ; Soloway, Mark ; Tomera, Kevin ; Katz, Giora ; Berger, Yitzhak ; Shen, Yu. / Detection of bladder cancer using a point-of-care proteomic assay. In: Journal of the American Medical Association. 2005 ; Vol. 293, No. 7. pp. 810-816.
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