Ask the Expert

Barry S. Stein, MD

1. Q - What are the likely causes of false positive results from the NMP22 BladderChek Test and what should the follow-up protocol be for patients with this conflicting diagnosis?

   A - There are of course two types of "false-positives" for this test. True false+ and that is usually due to infection or sources of inflammation such as calculi etc. Then there are the apparent false+ in which no tumor is seen, but eventually the test is shown to be correct. That is of course the real issue- separating those two. I would be careful to rule out the apparent false + by repeat endoscopy, perhaps with biopsy and upper tract imaging.

2. Q. Recent studies have suggested that the NMP22 BladderChek Test can be used as a "grading" tool. How can the test provide grading information?

   A - NMP 22 is not a grading tool per se. However, like most tests looking for cancer in the urine, it is more often positive with higher grade tumors. This is somewhat different than calling it a grading tool however.

3. Q - Is the NMP22 BladderChek Test helpful for diagnosing tumors in the upper tract and how does use of the test change traditional imaging protocols for the detection of tumors in the upper tract?

   A - NMP 22 does not care if the tumor is in the upper tract or the bladder when it is positive. As mentioned in Q#1, when the NMP is positive and no tumor is seen, the upper tract should be evaluated. This could be with CT scan or retrogrades.

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