PMID- 22386412
OWN - NLM
STAT- MEDLINE
DCOM- 20120518
LR  - 20220331
IS  - 1527-9995 (Electronic)
IS  - 0090-4295 (Linking)
VI  - 79
IP  - 3
DP  - 2012 Mar
TI  - Influence of urinary tract instrumentation and inflammation on the performance of 
      urine markers for the detection of bladder cancer.
PG  - 620-4
LID - 10.1016/j.urology.2011.10.067 [doi]
AB  - OBJECTIVE: To evaluate the impact of inflammation and sampling on cytology, 
      immunocytology, and fluorescence in situ hybridization (FISH) in comparison with 
      NMP22 in hematuria patients. The specificity of urine markers for urothelial 
      cancer is subject to exogenous factors. There is evidence that nuclear matrix 
      protein 22 (NMP22) is influenced by urinary tract infection and instrumented 
      urinary sampling (IUS). METHODS: Samples from 1386 patients with histologic 
      work-up were included. Cytology, immunocytology, FISH, and NMP22-enzyme-linked 
      immunosorbent assay were performed. The presence of inflammation was evaluated by 
      microscopy. The method of urine sampling was recorded in all cases. Any type of 
      urinary tract manipulation was considered as IUS. False-positive results were 
      compared with regard to the presence or absence of inflammation and mechanical 
      manipulation. RESULTS: In all, 1050 (75.7%) patients had no evidence of 
      urothelial cancer. NMP22 results were false positive in 74.3% and 38.4% of 
      patients with and without IUS (P < .0001). False-positive test rates of cytology, 
      immunocytology, and FISH were not increased after manipulation. Inflammation led 
      to a rise in false-positive NMP22 test results (85.3% vs 61.4%, P < .0001). The 
      presence of inflammation did not change the rate of false-positive cytology, 
      immunocytology, and FISH results. CONCLUSION: This is the first study to 
      investigate the impact of inflammation and IUS on cell-based urine markers. In 
      contrast to the protein test NMP22, these factors did not impair the performance 
      of cell-based tests. Hence, patients with positive cytology, immunocytology, and 
      FISH results should undergo diagnostic work-up, even in the case of concomitant 
      inflammation or IUS.
CI  - Copyright A(c) 2012 Elsevier Inc. All rights reserved.
FAU - Todenhofer, Tilman
AU  - Todenhofer T
AD  - Department of Urology, University Hospital, Tuebingen, Germany.
FAU - Hennenlotter, Jorg
AU  - Hennenlotter J
FAU - Kuhs, Ursula
AU  - Kuhs U
FAU - Tews, Veronika
AU  - Tews V
FAU - Gakis, Georgios
AU  - Gakis G
FAU - Aufderklamm, Stefan
AU  - Aufderklamm S
FAU - Stenzl, Arnulf
AU  - Stenzl A
FAU - Schwentner, Christian
AU  - Schwentner C
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Urology
JT  - Urology
JID - 0366151
RN  - 0 (Biomarkers, Tumor)
RN  - 0 (Nuclear Proteins)
RN  - 0 (nuclear matrix protein 22)
SB  - IM
CIN - Urology. 2012 Mar;79(3):625; author reply 625. PMID: 22386414
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Biomarkers, Tumor/*urine
MH  - Cystoscopy
MH  - False Positive Reactions
MH  - Humans
MH  - In Situ Hybridization, Fluorescence
MH  - Middle Aged
MH  - Nuclear Proteins/*urine
MH  - Sensitivity and Specificity
MH  - *Specimen Handling
MH  - Urinary Bladder Neoplasms/*complications/*diagnosis
MH  - Urinary Tract Infections/*complications
MH  - Young Adult
EDAT- 2012/03/06 06:00
MHDA- 2012/05/19 06:00
CRDT- 2012/03/06 06:00
PHST- 2011/09/04 00:00 [received]
PHST- 2011/10/07 00:00 [revised]
PHST- 2011/10/08 00:00 [accepted]
PHST- 2012/03/06 06:00 [entrez]
PHST- 2012/03/06 06:00 [pubmed]
PHST- 2012/05/19 06:00 [medline]
AID - S0090-4295(11)02690-2 [pii]
AID - 10.1016/j.urology.2011.10.067 [doi]
PST - ppublish
SO  - Urology. 2012 Mar;79(3):620-4. doi: 10.1016/j.urology.2011.10.067.