Selected research from leading health care experts whose findings have a direct bearing on public policies effecting medical progress. Research is chosen based on its quality and relevance by the Medical Progress Today editorial staff.

Selected Research

Detection of Bladder Cancer Using a Point-of-Care Proteomic Assay
H. Barton Grossman, MD, The Journal of the American Medical Association, 2-16-05

Pharmacogenomics and other “omics” sciences promise to move disease treatment and prevention from a medical art into a true science by identifying the underlying biological basis of human pathologies at the genetic and molecular levels.

This study recounts the success of a proteomic test used for the diagnosis of bladder cancer. Currently, “no single procedure detects all malignancies”, and although “urine test are frequently part of an evaluation” they have also “been either nonspecific for cancer or required specialized analysis at a laboratory.” The proteomic test used in this study measures the nuclear matrix protein NMP22 in voided urine.

“Participants included 1331 patients at elevated risk for bladder cancer due to factors such as history of smoking or symptoms including hematuria and dysuria. Patients at risk for malignancy of the urinary tract provided a voided urine sample for analysis of NMP22 protein and cytology prior to cystoscopy. Bladder cancer was diagnosed in 79 patients. The NMP22 assay was positive in 44 of 79 patients with cancer (sensitivity, 55.7%; 95% confidence interval [CI], 44.1%-66.7%), whereas cytology test results were positive in 12 of 76 patients (sensitivity, 15.8%; 95% CI, 7.6%-24.0%). The specificity of the NMP22 assay was 85.7% (95% CI, 83.8%-87.6%) compared with 99.2% (95% CI, 98.7%-99.7%) for cytology. The proteomic marker detected 4 cancers that were not visualized during initial endoscopy, including 3 that were muscle invasive and 1 carcinoma in situ.”

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