Objectives: 1.--To evaluate the efficacy of the NMP-22 as a diagnostic test for bladder tumor recidives; 2.--To compare the efficacy of NMP-22 vs. urine cytology.
Methods: 90 Patients with superficial bladder tumors were included in the study, undergoing cytologic, cystoscopic and NMP-22 marker controls. NMP 22 test was considered positive when the marker signal was higher than 10 U/ml. Cistoscopy was the reference test.
Results: Patients in the study had an average age of 69 years, ranging from 45 to 91. 88% were males and 12% females. 61.2% of the tumors were Ta, 37.6% T1 and 1.2% Cis, being 17.8% grade I, 63.4% grade II and 18.8% grade III. NMP-22 showed a global sensitivity of 32.1%, and a specificity of 5.1%. Positive predictive value (PPV) was 75% and negative predictive value (NPV) 75.3% for a relapse rate of 27.7%. Urine cytology showed an overall sensitivity of 28.6%, 95.2% specificity, PPV 72.7% and NPV 74.7%. When both tests were used altogether sensitivity was 46.4%, specificity 90.3%, PPV 68.43% and NPV 78.9%.
Conclusions: The NMP-22 marker has shown low sensitivity so that control by cystoscopy may not be avoided. The combination of NMP-22 and urine cytology increases sensitivity minimally. It is not possible to replace cystoscopy in the follow-up of patients with superficial bladder tumors.