Urinary levels of nuclear matrix protein 22 in patients with urinary diversion

To evaluate the influence of various types of urinary diversion on urinary nuclear matrix protein 22 (U-NMP22) levels.

U-NMP22 values were determined for 38 urinary diversion patients without upper urinary tract cancer. The patients were divided into three groups: tubeless cutaneous ureterostomy (n = 12), ileal conduit (n = 15), and continent urinary reservoir (n = 11). The mean values and false-positive rates of U-NMP22 (cutoff value 12 U/mL) were compared among the three groups.

The mean +/- standard error U-NMP22 value for the ureterostomy, ileal conduit, and reservoir groups was 20.1 +/- 5.8 U/mL, 335.6 +/- 63.5 U/mL, and 671.8 +/- 220.4 U/mL, respectively (P = 0.0030). The false-positive rate of U-NMP22 for the ureterostomy, ileal conduit, and reservoir groups was 41.7%, 100%, and 100%, respectively. In the ureterostomy group, the exclusion of patients with pyuria improved the false-positive rate of U-NMP22 from 41.7% to 12.5%.

U-NMP22 levels may be useful in the diagnosis of upper urinary tract cancer in patients with a tubeless cutaneous ureterostomy. However, in patients with urinary diversion using a bowel segment, U-NMP22 has no diagnostic value because of the high U-NMP22 levels.