[Cytokeratins (UBC and CYFRA 21-1) and nuclear matrix proteins (NMP22) as urine tumor markers in the diagnosis of bladder cancer].
BACKGROUND
The development of urinary tumor markers such as UBC, CYFRA 21-1 and NMP22 appeared to be non invasive alternative methods for the detection of bladder cancer. We compared the individual and combined sensitivity of the urinary tumor markers in the detection of bladder cancer, contrasting them with the conventional diagnostic procedures.


METHODS
237 voided urines from subjects under risk for bladder cancer were collected immediately before the endoscopic examinations: 44 patients under suspicion of a primary bladder tumor and 193 patients under follow-up of a previous bladder cancer were included. UBC and NMP22 were measured by enzyme-immunoabsorbent-assays and CYFRA 21-1 by an electro-chemiluminescense-immunoassay.


RESULTS
Taking the cutoffs of 9.7 micrograms/l for UBC, 5.4 ng/ml for CYFRA 21-1 and 10.0 U/ml for NMP22 sensitivities were 70%, 69% and 67% for UBC, CYFRA 21-1 and NMP22 at specificities of 95%, 94% y 80%, respectively. All tumor markers showed higher sensitivities than urinary cytology (7%), microhematuria (62%) and gross hematuria (10%) at specificities of 99%, 78% and 99%, respectively. The combinations of NMP22 plus CYFRA 21-1 reached the highest sensitivity (79%), slightly lower than simultaneously measuring the three tumor markers (80%).


CONCLUSIONS
The sensitivities of the urinary markers UBC, CYFRA 21-1 and NMP22 appeared to be high enough so as to substitute urinary cytology. The diagnostic similarity between cytokeratins individually and in each type of patients might not recommend their simultaneous determination. The combined measurement of NMP22 and one cytokeratin marker (CYFRA 21-1 or UBC) appeared to be the most recommended.
Sánchez-Carbayo
M
M
Laboratorio de Marcadores Tumorales, Hospital Universitario de Salamanca.
Urrutia
M
M
Hernández-Cerceño
M L
ML
González de Buitrago
J M
JM
Navajo
J A
JA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000951:Antigens, Neoplasm; D034961:Antigens, Nuclear; D015415:Biomarkers / Q000652:urine; D014408:Biomarkers, Tumor / Q000652:urine*; D005260:Female; D006801:Humans; D053539:Keratin-19; D007633:Keratins / Q000652:urine*; D008297:Male; D008875:Middle Aged; D009687:Nuclear Proteins / Q000652:urine*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis* / Q000652:urine*
D000951:Antigens, Neoplasm; D034961:Antigens, Nuclear; D015415:Biomarkers; D014408:Biomarkers, Tumor; D053539:Keratin-19; D009687:Nuclear Proteins; C102012:antigen CYFRA21.1; D007633:Keratins