The tumor marker NMP22 – nuclear matrix protein 22 – (synonyms: Nuclear Matrix Protein 22; NMP22; NMP22 BladderChek Test; NMP22 Urinary Bladder Cancer Test) is a tumor-associated marker used for the early diagnosis of urinary bladder cancer as well as the follow-up examinations of urinary bladder cancer.About three percent of all cancers are carcinomas of the urinary bladder, also called bladder cancer. The most common form of bladder cancer is urothelial carcinoma, which accounts for 95% of all malignant (malignant) bladder tumors. Every year, around 18,000 men and 9,000 women develop this type of tumor in Germany, making urinary bladder cancer one of the most common types of cancer in men. The risk of developing the disease increases with age from the age of 40. The median age of onset is 68 years for men and 73 years for women.A major risk factor for developing bladder cancer is smoking. Smoking is responsible for about half of all cases of the disease in men and about one in three cases of the disease in women.
Causes
The following are the risk factors for developing bladder cancer:
- Smoking (threefold increased risk of disease) – because of the aromatic amines contained in tobacco smoke.
- Aromatic amines in drugs – for example, cyclophosphamide-based cytostatics.
- Other chemical substances in workers in the petrochemical, textile, leather or paint industries.
- Hairdressers
- Truck drivers
- Painter
- Tank attendants
- Patients with chronic urinary bladder infections.
Up to forty years elapse between exposure to the carcinogens and the development of cancer, which means that the latency period is very long.Cofactors – with causative factors – for the development of urinary bladder cancer are:
- Weakened immune system
- Immunosuppressants – for example, after organ transplantation.
- Chronic urinary tract infections
Symptoms
No early symptoms, that is, in the early development phase of the cancer, there are no symptoms, so there are no warning signs in the early stages.More than eight out of ten of the patients notice a reddish to brown coloration of the urine, which is caused by bleeding of the tumor (hematuria). This bleeding is usually painless.Frequent urination (pollakiuria) is experienced by about three in ten of those affected, with only a small amount of urine being emptied at any one time.Advanced bladder cancer may be associated with palpable tumor in the abdomen, lymphadenopathy (enlargement of lymph nodes), lymph or venous congestion, pain of the lateral trunk of the body, or bone pain.
Diagnostics
The following are the diagnostic steps:
- Palpatory examination of the lower abdomen and internal genitalia.
- Sonography – ultrasound examination of the lower abdominal region, urinary bladder and kidneys.
- Urethrocystoscopy – urethral and bladder endoscopy, with a biopsy (tissue sampling) if necessary.
- Urography – X-ray contrast imaging of the kidneys, ureters and urinary bladder.
- Urinary cytology – examination of urine for tumor cells, bacteria, urinary cylinders – which are deposits that form in the renal tubules, etc.
Urine cytology is a good method that requires great experience of the cytologist. For example, severe inflammatory changes can in rare cases lead to false positive findings, that is, the cytologist falsely suspects bladder cancer. On the other hand, in the early phase of the disease, only a few cancer cells or precancerous cells can be detected in the urine, so that in rare cases a normal finding is made incorrectly.This is where the NMP22 urinary bladder cancer test, which is used successfully in the early diagnosis of urinary bladder cancer, can help: The test is usually performed in the doctor’s office. Only the test kit and a few drops of patient urine are needed. The test result is available within 30 minutes. The NMP22 urinary bladder cancer test is very specific, meaning false positive findings are rare.
Interpretation
Positive results do not equate to tumor detection!Negative results do not mean tumor exclusion! False-positive results:
- False stabilizer or unstabilized urine.
- Recent surgery
- Some benign (benign) bladder diseases
- Patients under or after chemotherapy
NMP22 has been approved by the FDA for screening and monitoring in urinary bladder cancer.Sensitivity (percentage of diseased patients in whom the disease is detected by use of the test, i.e., a positive test result occurs) 47-100 %; Specificity (probability that actually healthy individuals who do not have the disease in question are also detected as healthy by the test) 55-98 %, depending on tumor stage; for high-grade tumors (undifferentiated or anaplastic malignant tissue) 75-83%Caution (Warning)!NMP22 is not able to replace cystoscopy (cystoscopy of the bladder) or preselect patients for cystoscopy.In a multicenter study, a combination of cystoscopy and urinalysis for NMP22 detected nearly 94 percent of affected patients.
Benefit
The NMP22 urinary bladder cancer test is a safe measure to detect urinary bladder cancer early and thus in time for successful treatment of the disease.
