Abstract

Objectives: The frequency of bladder cancer is third in men, tenth in women among the all malignancy. Macroscopic or microscopic hematuria is present in 85-90% of the patients. Urine analyse, radiological evaluation, cystoscopy and pathologic study are made for diagnosis. Simple, non-invasive, cheaper, more reliable and more sensitive methods were investigated as alternative to the cystoscopy that is an invasive technique, such as, urine cytology, flow cytometry, tissue plasminogen activator, CEA, Thomson Friedenreich antigen, ABH-O blood group antigens, bladder cancer antigen, proteolitic enzymes, plasminogen activators, extracellular matrix protein and receptors, cell adhesion proteins, epidermal and tumor growth factors and receptors, proving of the chromosome and genetic alterations, hyaluronic acide-hyaluronidase, fibrin and fibrinogen destructive products, telomerase were studied. Nuclear matrix protein is the one of these methods that can be determined. It was considered that the high level of NMP22 in urine was correlated with overgrowth of the cell and tumor. NMP22 is the part of the nucleus of the cell; it obtains the regulation of the gene expression, DNA replication and transcriptions. Cystoscopy is a gold standard to evaluate hematuria because of the bladder cancer. It obtains a macroscopic view, the chance of biopsy and histopathology study. But cystoscopy is an invasive method. Diminish the frequency of the cystoscopy for following up the bladder cancer, may be preferred by these patients.

Material and methods: In this study, we compared the NMP22 that was so simple for diagnose and followed up of bladder cancer and cystoscopy to diagnose bladder cancer successfully. For this reason 93 patients, 65 male, 28 female, the average age was 53.6, that were diagnosed as a bladder cancer, were investigated according to whether the primer or recurrent bladder cancer, papillary or solid, single or multiple, the grade and stage of tumor. The cut-off value of NMP22 was 10 U/ml.

Result: Comparison was made among the tumor number, bigness, primer or recurrent, solid or papillary and the values of NMP22, the correlation was not significant statistically (p>0.05). TUR was performed after the recognition of tumor in cystoscopy. Pathologic specimens were separated in 3 groups according to the degrees. While the differences between degree I and II, degree II and III were not significant statistically (p>0.05), the difference between degree I and III was significant (p<0.05). Pathologic staging were made as Ta, T1, T2, and T3. Between Ta and T1, T2 and T3, differences were not significant (p>0.05). However, the differences was also determined between Ta and the other stages, T1 and T2, T3 (p<0.05).

Conclusion: Sensitivity 65%, specific 56%, false negative 35%, false positive 44%, positive determining 65%, negative determining 56% were confirmed. However, it showed that NMP22 was insufficient about the diagnosis of tumor and extension of the interval of the control cystoscopy.