What is the role of the NMP-22 assay in the diagnosis of bladder cancer?

Updated: Nov 01, 2018
  • Author: Gary David Steinberg, MD, FACS; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Nuclear matrix, first described in 1974, is the nonchromatin structure that supports nuclear shape and organizes DNA. It also takes part in DNA replication and transcription, as well as RNA processing. [16, 17, 18]

NMP-22 is involved in the proper distribution of chromatin to daughter cells during cell division and is found in the nuclear matrix of all cell types. NMP-22 is thought to be released from the nuclei of tumor cells after they die and can be detected in the urine. Research has found that persons with bladder cancer may have urinary NMP-22 levels up to 25 times that in healthy persons. [19]

The NMP-22 BladderChek test (Alere; Waltham, Mass) is an in vitro immunoassay intended for the qualitative detection of NMP-22 in urine. Unlike cytologic analysis, the NMP-22 test does not depend on intact cells and does not require expert analysis or laboratory time. The test provides an absolute positive or negative test result, much in the same manner as a pregnancy test.

It is a painless and noninvasive assay that provides results within 30 minutes (thus allowing performance during an office visit), and its cost is less than half that of cytology. It is the only in-office test approved by the FDA in 2000 for the diagnosis of bladder cancer.

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