RESUMO
Bladder cancer is a malignancy that affects mainly the elderly and males. Up to 90% of these cancers originate from urothelial epithelial cells and therefore they are called Transitional (Urothelial) Cell Carcinoma (TCC). Another types are: Squamous Cell Carcionoma (SCC), which involves about 5% of cases and Adenocarcinoma (less than 2%). The factors that may lead to the development of bladder cancer include: genetic disorders, molecular changes, environmental exposures, industrial carcinogens, chemical contaminants and chronic cystitis. This article depicts the current state of diagnostics of bladder cancer, with particular focus on urine-based tests. Although many markers with different structure are under research, only the following have gained FDA approval for bladder cancer screening: BTAstat, BTA TRAK, UroVysion and NMP22 BladderChek. For follow-up NMP22 ELISA and Immunocyt (uCyt+) are approved. This work is mainly focused on mainly on evaluating the diagnostic value of nuclear matrix protein NMP22 for bladder cancer in terms of the outlined researches among people susceptible to environmental toxins. A review of the current literature depicts that no research on correlation between NMP22 and genetic susceptibility has been conducted so far. There is some evidence that NMP22 protein is particularly important in high-risk groups, e.g. among tobacco smokers. The work also describes the methods of detecting NMP22 protein and factors that may influence the results. The review of current literature showed that NMP22 cannot replace invasive cystoscopy neither in screening for bladder cancer nor in follow-up. The NMP22 test could be useful for determining the frequency of cystoscopy and for early detection of high-grade tumors. Research focused on improving the specificity of this marker seems to be crucial, e.g. through the correlation between NMP22 and other parameters (e.g. other laboratory tests), which is confirmed by preliminary data about combining various markers.
