Impact of risk factors on the performance of the nuclear matrix protein 22 point-of-care test for bladder cancer detection

Yair Lotan, Shahrokh F. Shariat, Yitzhak Berger, David Bock, Jeffrey Brady, M. Patrick Collini, Martin Dineen, H. Barton Grossman, Vahan Kassabian, Giora Katz, Shiva Maralani, Edward Messing, Raoul Salup, Mark Soloway, Barry Stein, Kevin Tomera, Alan Treiman

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

OBJECTIVES: To evaluate the impact of different risk factors and symptoms on the performance characteristics of the nuclear matrix protein 22 (NMP22) BladderChek® test (Matritech Inc., Newton, MA, USA) for the detection of bladder cancer, as this is a point-of-care assay that measures NMPs in voided urine. PATIENTS AND METHODS: In all, 23 academic, private practice and veterans' facilities in 10 states prospectively enrolled consecutive patients from September 2001 to May 2002. Participants included 1328 patients at elevated risk of bladder cancer from factors such as a history of smoking or symptoms including haematuria and/or dysuria. Patients at risk of malignancy of the urinary tract provided a voided urine sample for analysis of NMP22 protein and cytology before cystoscopy. RESULTS: Of the 1328 patients: no urinary disease, benign disease and malignancy were found in 545 (41%), 704 (53%) and 79 (6%) patients, respectively. Overall, the positive predictive value (PPV) for detection of bladder cancer was 20.3% (45/222) and negative predictive value (NPV) was 96.9% (1072/1106). The PPV was higher in men (24.0%) than women (13.2%). In men, the PPV increased with smoking (35.4%), gross haematuria (51.2%) and a combination of both factors (70.6%). The impact on the PPV of smoking (9.7%) and gross haematuria (28.6%) was less dramatic in women. The PPV increased from 16.8% in patients aged <65 years to 23.5% in those aged >65 years. The NPV remained almost always >95% except in men with gross haematuria where it decreased to 77% in smokers and 94% in non-smokers. CONCLUSION: The PPV of the BladderChek test improves in patients at higher risk of bladder cancer reaching 77% in men presenting with gross haematuria who are aged >65 years and smoke. The NPV is highest in women aged <65 years, up to 100%.

Original languageEnglish
Pages (from-to)1362-1367
Number of pages6
JournalBJU International
Volume101
Issue number11
DOIs
StatePublished - Jun 1 2008
Externally publishedYes

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Point-of-Care Systems
Urinary Bladder Neoplasms
Hematuria
Smoking
Urine
Predictive Value of Tests
Dysuria
Cystoscopy
Private Practice
Veterans
nuclear matrix protein 22
Urinary Tract
Smoke
Cell Biology
Neoplasms

Keywords

  • Age
  • Bladder cancer
  • NMP22
  • Performance characteristics
  • Smoking
  • Urine-based markers

ASJC Scopus subject areas

  • Urology

Cite this

Impact of risk factors on the performance of the nuclear matrix protein 22 point-of-care test for bladder cancer detection. / Lotan, Yair; Shariat, Shahrokh F.; Berger, Yitzhak; Bock, David; Brady, Jeffrey; Collini, M. Patrick; Dineen, Martin; Grossman, H. Barton; Kassabian, Vahan; Katz, Giora; Maralani, Shiva; Messing, Edward; Salup, Raoul; Soloway, Mark; Stein, Barry; Tomera, Kevin; Treiman, Alan.

In: BJU International, Vol. 101, No. 11, 01.06.2008, p. 1362-1367.

Research output: Contribution to journalArticle

Lotan, Y, Shariat, SF, Berger, Y, Bock, D, Brady, J, Collini, MP, Dineen, M, Grossman, HB, Kassabian, V, Katz, G, Maralani, S, Messing, E, Salup, R, Soloway, M, Stein, B, Tomera, K & Treiman, A 2008, 'Impact of risk factors on the performance of the nuclear matrix protein 22 point-of-care test for bladder cancer detection', BJU International, vol. 101, no. 11, pp. 1362-1367. https://doi.org/10.1111/j.1464-410X.2008.07473.x
Lotan, Yair ; Shariat, Shahrokh F. ; Berger, Yitzhak ; Bock, David ; Brady, Jeffrey ; Collini, M. Patrick ; Dineen, Martin ; Grossman, H. Barton ; Kassabian, Vahan ; Katz, Giora ; Maralani, Shiva ; Messing, Edward ; Salup, Raoul ; Soloway, Mark ; Stein, Barry ; Tomera, Kevin ; Treiman, Alan. / Impact of risk factors on the performance of the nuclear matrix protein 22 point-of-care test for bladder cancer detection. In: BJU International. 2008 ; Vol. 101, No. 11. pp. 1362-1367.
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AU - Lotan, Yair

AU - Shariat, Shahrokh F.

AU - Berger, Yitzhak

AU - Bock, David

AU - Brady, Jeffrey

AU - Collini, M. Patrick

AU - Dineen, Martin

AU - Grossman, H. Barton

AU - Kassabian, Vahan

AU - Katz, Giora

AU - Maralani, Shiva

AU - Messing, Edward

AU - Salup, Raoul

AU - Soloway, Mark

AU - Stein, Barry

AU - Tomera, Kevin

AU - Treiman, Alan

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N2 - OBJECTIVES: To evaluate the impact of different risk factors and symptoms on the performance characteristics of the nuclear matrix protein 22 (NMP22) BladderChek® test (Matritech Inc., Newton, MA, USA) for the detection of bladder cancer, as this is a point-of-care assay that measures NMPs in voided urine. PATIENTS AND METHODS: In all, 23 academic, private practice and veterans' facilities in 10 states prospectively enrolled consecutive patients from September 2001 to May 2002. Participants included 1328 patients at elevated risk of bladder cancer from factors such as a history of smoking or symptoms including haematuria and/or dysuria. Patients at risk of malignancy of the urinary tract provided a voided urine sample for analysis of NMP22 protein and cytology before cystoscopy. RESULTS: Of the 1328 patients: no urinary disease, benign disease and malignancy were found in 545 (41%), 704 (53%) and 79 (6%) patients, respectively. Overall, the positive predictive value (PPV) for detection of bladder cancer was 20.3% (45/222) and negative predictive value (NPV) was 96.9% (1072/1106). The PPV was higher in men (24.0%) than women (13.2%). In men, the PPV increased with smoking (35.4%), gross haematuria (51.2%) and a combination of both factors (70.6%). The impact on the PPV of smoking (9.7%) and gross haematuria (28.6%) was less dramatic in women. The PPV increased from 16.8% in patients aged <65 years to 23.5% in those aged >65 years. The NPV remained almost always >95% except in men with gross haematuria where it decreased to 77% in smokers and 94% in non-smokers. CONCLUSION: The PPV of the BladderChek test improves in patients at higher risk of bladder cancer reaching 77% in men presenting with gross haematuria who are aged >65 years and smoke. The NPV is highest in women aged <65 years, up to 100%.

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