Surveillance for Recurrent Bladder Cancer Using a Point-of-Care Proteomic Assay

摘要: ContextAt least 50% of patients with a history bladder cancer have recurrences, so rigorous surveillance is necessary. Cystoscopy standard but can fail to detect some cancers, urine test frequently part the evaluation.ObjectiveTo investigate whether point-of-care proteomic that measures nuclear matrix protein NMP22 in voided could improve detection recurrence during monitoring cancer.Design, Setting, and PatientsFrom September 2001 February 2002, 23 academic, private practice, hospital facilities 9 US states prospectively enrolled 668 consecutive this cross-sectional study. Patients provided sample for analysis cytology prior cystoscopy.Main Outcome MeasuresDiagnosis recurrence, based on cystoscopy biopsy, was accepted as reference standard. The performance compared an aid detection. Testing tumor marker conducted blinded manner.ResultsBladder diagnosed 103 patients. alone identified 91.3% cancers (94/103; 95% confidence interval [CI], 84.1%-95.9%). combination assay detected 99.0% malignancies (102/103; CI, 94.7%-100%; P = .005). 8 were not visualized initial cystoscopy, including 7 high-grade. sensitivity specificity 49.5% (51/103; 39.5%-59.5%) 87.3% (493/565; 84.2%-89.9%), respectively. Voided only 3 missed did significantly increase (94.2%; 87.7%-97.8%; P = .08).ConclusionThe noninvasive elevated urinary ability recurrent cancer, results available patient visit.