Impact of clinical factors, including a point-of-care nuclear matrix protein-22 assay and cytology, on bladder cancer detection

Yair Lotan, Umberto Capitanio, Shahrokh F. Shariat, Georg C. Hutterer, Pierre I. Karakiewicz

Research output: Contribution to journalArticle

51 Citations (Scopus)

Abstract

OBJECTIVE To determine whether the nuclear matrix protein-22 (NMP22) assay can improve the accuracy of discriminating between high-risk patients with and without bladder cancer. PATIENTS AND METHODS Age, gender, race, smoking status, haematuria and its extent, and the NMP22 and urinary cytology results, were available for 1272 patients. The data of 670 (52.7%) from four study sites were used to develop a logistic regression model-based nomogram to predict the presence of bladder cancer. The remaining data from 602 (47.3%) patients from nine study sites were used to externally validate the nomogram. A separate nomogram was developed for urinary cytology, and for the combination of NMP22 and urinary cytology findings. RESULTS Of 1272 patients, 76 (6.0%) had bladder cancer, 217 (17.1%) were NMP22-positive and 17 (1.3%) had malignant cells on urinary cytology. NMP22 and urinary cytology results were independent predictors of bladder cancer (P = 0.005 and 0.007, respectively). In external validation, the area under the curve (AUC) for NMP22 was 76.0% vs 56.2% for cytology. External validation of the multivariable NMP22-based bladder cancer nomogram gave an AUC of 82.4% vs 74.7% for the multivariable cytology-based nomogram (gain 7.7%; P = 0.006) vs 82.6% for the multivariable nomogram combining NMP22 and cytology results (gain 0.2%; P = 0.1). CONCLUSIONS The ability of the NMP22 test to predict bladder cancer in high-risk patients significantly exceeds that of urinary cytology. The NMP22-based nomogram can help to identify individuals at risk of bladder cancer.

Original languageEnglish (US)
Pages (from-to)1368-1374
Number of pages7
JournalBJU International
Volume103
Issue number10
DOIs
StatePublished - 2009

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Point-of-Care Systems
Urinary Bladder Neoplasms
Cell Biology
Nomograms
Area Under Curve
Logistic Models
nuclear matrix protein 22
Aptitude
Hematuria
Smoking

Keywords

  • Bladder cancer
  • Cytology
  • Detection
  • NMP22
  • Tumour marker

ASJC Scopus subject areas

  • Urology

Cite this

Impact of clinical factors, including a point-of-care nuclear matrix protein-22 assay and cytology, on bladder cancer detection. / Lotan, Yair; Capitanio, Umberto; Shariat, Shahrokh F.; Hutterer, Georg C.; Karakiewicz, Pierre I.

In: BJU International, Vol. 103, No. 10, 2009, p. 1368-1374.

Research output: Contribution to journalArticle

Lotan, Yair ; Capitanio, Umberto ; Shariat, Shahrokh F. ; Hutterer, Georg C. ; Karakiewicz, Pierre I. / Impact of clinical factors, including a point-of-care nuclear matrix protein-22 assay and cytology, on bladder cancer detection. In: BJU International. 2009 ; Vol. 103, No. 10. pp. 1368-1374.
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abstract = "OBJECTIVE To determine whether the nuclear matrix protein-22 (NMP22) assay can improve the accuracy of discriminating between high-risk patients with and without bladder cancer. PATIENTS AND METHODS Age, gender, race, smoking status, haematuria and its extent, and the NMP22 and urinary cytology results, were available for 1272 patients. The data of 670 (52.7{\%}) from four study sites were used to develop a logistic regression model-based nomogram to predict the presence of bladder cancer. The remaining data from 602 (47.3{\%}) patients from nine study sites were used to externally validate the nomogram. A separate nomogram was developed for urinary cytology, and for the combination of NMP22 and urinary cytology findings. RESULTS Of 1272 patients, 76 (6.0{\%}) had bladder cancer, 217 (17.1{\%}) were NMP22-positive and 17 (1.3{\%}) had malignant cells on urinary cytology. NMP22 and urinary cytology results were independent predictors of bladder cancer (P = 0.005 and 0.007, respectively). In external validation, the area under the curve (AUC) for NMP22 was 76.0{\%} vs 56.2{\%} for cytology. External validation of the multivariable NMP22-based bladder cancer nomogram gave an AUC of 82.4{\%} vs 74.7{\%} for the multivariable cytology-based nomogram (gain 7.7{\%}; P = 0.006) vs 82.6{\%} for the multivariable nomogram combining NMP22 and cytology results (gain 0.2{\%}; P = 0.1). CONCLUSIONS The ability of the NMP22 test to predict bladder cancer in high-risk patients significantly exceeds that of urinary cytology. The NMP22-based nomogram can help to identify individuals at risk of bladder cancer.",
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T1 - Impact of clinical factors, including a point-of-care nuclear matrix protein-22 assay and cytology, on bladder cancer detection

AU - Lotan, Yair

AU - Capitanio, Umberto

AU - Shariat, Shahrokh F.

AU - Hutterer, Georg C.

AU - Karakiewicz, Pierre I.

PY - 2009

Y1 - 2009

N2 - OBJECTIVE To determine whether the nuclear matrix protein-22 (NMP22) assay can improve the accuracy of discriminating between high-risk patients with and without bladder cancer. PATIENTS AND METHODS Age, gender, race, smoking status, haematuria and its extent, and the NMP22 and urinary cytology results, were available for 1272 patients. The data of 670 (52.7%) from four study sites were used to develop a logistic regression model-based nomogram to predict the presence of bladder cancer. The remaining data from 602 (47.3%) patients from nine study sites were used to externally validate the nomogram. A separate nomogram was developed for urinary cytology, and for the combination of NMP22 and urinary cytology findings. RESULTS Of 1272 patients, 76 (6.0%) had bladder cancer, 217 (17.1%) were NMP22-positive and 17 (1.3%) had malignant cells on urinary cytology. NMP22 and urinary cytology results were independent predictors of bladder cancer (P = 0.005 and 0.007, respectively). In external validation, the area under the curve (AUC) for NMP22 was 76.0% vs 56.2% for cytology. External validation of the multivariable NMP22-based bladder cancer nomogram gave an AUC of 82.4% vs 74.7% for the multivariable cytology-based nomogram (gain 7.7%; P = 0.006) vs 82.6% for the multivariable nomogram combining NMP22 and cytology results (gain 0.2%; P = 0.1). CONCLUSIONS The ability of the NMP22 test to predict bladder cancer in high-risk patients significantly exceeds that of urinary cytology. The NMP22-based nomogram can help to identify individuals at risk of bladder cancer.

AB - OBJECTIVE To determine whether the nuclear matrix protein-22 (NMP22) assay can improve the accuracy of discriminating between high-risk patients with and without bladder cancer. PATIENTS AND METHODS Age, gender, race, smoking status, haematuria and its extent, and the NMP22 and urinary cytology results, were available for 1272 patients. The data of 670 (52.7%) from four study sites were used to develop a logistic regression model-based nomogram to predict the presence of bladder cancer. The remaining data from 602 (47.3%) patients from nine study sites were used to externally validate the nomogram. A separate nomogram was developed for urinary cytology, and for the combination of NMP22 and urinary cytology findings. RESULTS Of 1272 patients, 76 (6.0%) had bladder cancer, 217 (17.1%) were NMP22-positive and 17 (1.3%) had malignant cells on urinary cytology. NMP22 and urinary cytology results were independent predictors of bladder cancer (P = 0.005 and 0.007, respectively). In external validation, the area under the curve (AUC) for NMP22 was 76.0% vs 56.2% for cytology. External validation of the multivariable NMP22-based bladder cancer nomogram gave an AUC of 82.4% vs 74.7% for the multivariable cytology-based nomogram (gain 7.7%; P = 0.006) vs 82.6% for the multivariable nomogram combining NMP22 and cytology results (gain 0.2%; P = 0.1). CONCLUSIONS The ability of the NMP22 test to predict bladder cancer in high-risk patients significantly exceeds that of urinary cytology. The NMP22-based nomogram can help to identify individuals at risk of bladder cancer.

KW - Bladder cancer

KW - Cytology

KW - Detection

KW - NMP22

KW - Tumour marker

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