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Test can rule out bladder cancer in hematuria.(Clinical Rounds)
PARIS -- The noninvasive NMP22 BladderChek assay gives primary care physicians a way to screen asymptomatic patients with hematuria for bladder cancer during office visits, Dr. H. Barton Grossman said at the annual congress of the European Association of Urology.
"At least in the United States, most of these patients are not being tested at all, not being referred to urologists, until they have several episodes of significant blood in their urine," said Dr. Grossman, professor and chairman of urology at the M.D. Anderson Cancer Center in Houston.
The test, approved for use in the United States and Europe, uses four drops of urine and gives results in 30 minutes at a cost of $25-$50 per patient, according to Dr. Grossman. A positive finding is based on an NMP22 antigen level of 10 U/mL or greater. Malignant cancer cells have been found with concentrations up to 80 times greater than those found in normal cells, he said.
"I think the best use of this test is actually going to be in the initial diagnosis of people with hematuria in general practice offices," he told European urologists who questioned whether the NMP22 protein assay yields too many false-positive results for urologists to find it clinically useful.
Dr. Grossman presented updated results from a large study that found that the NMP22 protein assay can increase the accuracy of screening when used in combination with cystoscopy (JAMA 2005;293:810-6). The investigators compared the NMP22 test results with cytology results, with cystoscopy as the reference standard. Patients provided a voided urine sample before undergoing cystoscopy. The urine sample was divided into two parts: One portion was tested for NMP22 in the office, and the other was sent for routine cytology. If a tumor was found and removed during cystoscopy, diagnosis was based on pathology of the tumor.
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Source: HighBeam Research, Test can rule out bladder cancer in hematuria.(Clinical Rounds)