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Urinary levels of nuclear matrix protein-22 in pregnant and non-pregnant women
International Journal of Gynecology and Obstetrics (2005) 89, 138 — 139
www.elsevier.com/locate/ijgo
BRIEF COMMUNICATION
Urinary levels of nuclear matrix protein-22 in pregnant and non-pregnant women M.A. Guvena,*, M. Kilincb, C. Batukanc a
Department of Obstetrics and Gynecology, Kahramanmaras Sutcuimam University, School of Medicine, Kahramanmaras, Turkey b Department of Biochemistry, Kahramanmaras Sutcuimam University, School of Medicine, Kahramanmaras, Turkey c Department of Obstetrics and Gynecology, Erciyes University, School of Medicine, Kayseri, Turkey Received 8 December 2004; accepted 12 January 2005
KEYWORDS Urine nuclear matrix protein 22; Pregnancy; Tumor marker; Urinary tract tumour
Several tumor markers are significantly elevated during the course of pregnancy. The underlying cause of this rise may be related to the trophoblastic activity of the placenta [1]. Certain nuclear matrix proteins (NMPs) have also been identified as cancer specific markers among human colon, breast and bone cancer. They are detectable in voided urine [2]. Nuclear matrix protein 22 (NMP-22) has been shown to be a useful tumour marker for
T Corresponding author. Yenisehir Mh., Cumhuriyet Blv., Gunes Apt. B Blok, #14/18, 46100, Kahramanmaras/Turkey. Tel.: +90 344 221 23 37; fax: +90 344 221 23 71. E-mail address: [email protected] (M.A. Guven).
identifying recurrence of transitional cell carcinoma of the urinary tract [3]. However, its urinary level in pregnancy has not been investigated yet. Our aim was to investigate this latter issue. The urinary NMP-22 levels of 64 healthy pregnant women were measured at different gestational ages and 18 age matched non-pregnant healthy women in a spot morning urine sample using the commercially available NMP-22 test kit. Statistical analysis was performed using the Student’s T-test and Pearson’s two-tailed method. The results are given in meansFstandard deviation (S.D.). The age of pregnant women in the first, second, and third trimester and those of nonpregnant controls was (XFS.D.: meanFstandard deviation; range) 25.7F4.9 (20—37), 28.7F6.2 (20—42), 25.6F4.5 (18—35) and 27.9F5.8 (19— 37), respectively ( pN0.05). Urinary NMP-22 levels are shown at Table 1. There was also an increase of urinary NMP-22 with advancing gestational age ( pb0.01; Fig. 1). This is the first study showing that urinary NMP22 levels tend to increase with advancing gesta-
0020-7292/$ - see front matter D 2005 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.ijgo.2005.01.030
Urinary levels of nuclear matrix Table 1 group
139
Comparison of urinary NMP-22 values according to trimesters in healthy pregnant women and control
State
Non-pregnant control (n=18)
Pregnant women in the first trimester (n=20)
Pregnant women in the second trimester (n=21)
Pregnant women in the third trimester (n=23)
Mean urinary NMPFS.D. (U/ml) Range
2.30F1.38a,b
3.24F2.26c,d
5.42F2.4a,c,e
6.75F3.15b,d,e
0.24—4.98
0.27—9.80
0.89—9.51
0.73—12.66
a
Urinary NMP 22 (U/ml)
pb0.01, urinary NMP-22 level of patients in the second trimester compared with those in the first trimester and non-pregnant controls. b pb0.01, urinary NMP-22 level of patients in the third trimester compared with those in the first trimester and non-pregnant controls. c pb0.05, urinary NMP-22 level of patients in the second trimester compared with those in the first trimester and non-pregnant controls. d pb0.05, urinary NMP-22 level of patients in the third trimester compared with those in the first trimester and non-pregnant controls. e pN0.05, no significant difference was observed in the urinary levels of NMP-22 between patients in the second and third trimester.
8 6 4 2 0 Control group
1. Trimester
2. Trimester
3. Trimester
Figure 1 Comparison of urinary nuclear matrix protein 22 according to trimesters in healthy pregnant women and control group.
tional age. As only urinary NMP-22 concentrations were determined, however, no comment on concomitant blood levels can be made. As NMP-22 is normally secreted into the urine by transitional epithelium of the urinary tract, it is unlikely that it will be detectable in serum. This is further supported by studies showing that screening for urinary tract tumors of the urinary tract is only effective when performed in urine and not serum [2,3]. The increase of urinary NMP-22 in pregnancy is highly attributable to the increase in urinary output, as urinary output increases up to 50% beginning at the end of the first trimester [4]. The results presented here were obtained from healthy pregnant and non-pregnant women; therefore cut-off levels, which may aid in detecting urinary tract tumors, cannot be established. Further studies are needed to make clear statements about the sensitivity and specificity of
urinary NMP-22 determination as a screening tool in pregnancy.
References [1] Kobayashi F, Sagawa N, Nanbu Y, Nakamura K, Nonogaki M, Ban C, et al. Immunohistochemical localization and tissue levels of tumour-associated glycoproteins Ca 125 and Ca 19-9 in the decidua and fetal membranes at various gestational ages. Am J Obstet Gynecol 1989;160:1232 – 8. [2] Sawczuk IS, Lee B. The mechanism and clinical application of the NMP-22 tumour marker immunoassay: a review. Am Clin Lab 1999;18:24 – 6. [3] Carpinito GA, Stadler WM, Briggman JW, Chodak GW, Church PA, Lamm DL, et al. Urinary nuclear matrix protein as a marker for transitional cell carcinoma of the urinary tract. J Urol 1996;156:1280 – 5. [4] Dunlop W. Serial changes in renal haemodynamics during normal human pregnancy. Br J Obstet Gynaecol 1981;88:1 – 9.
www.elsevier.com/locate/ijgo
BRIEF COMMUNICATION
Urinary levels of nuclear matrix protein-22 in pregnant and non-pregnant women M.A. Guvena,*, M. Kilincb, C. Batukanc a
Department of Obstetrics and Gynecology, Kahramanmaras Sutcuimam University, School of Medicine, Kahramanmaras, Turkey b Department of Biochemistry, Kahramanmaras Sutcuimam University, School of Medicine, Kahramanmaras, Turkey c Department of Obstetrics and Gynecology, Erciyes University, School of Medicine, Kayseri, Turkey Received 8 December 2004; accepted 12 January 2005
KEYWORDS Urine nuclear matrix protein 22; Pregnancy; Tumor marker; Urinary tract tumour
Several tumor markers are significantly elevated during the course of pregnancy. The underlying cause of this rise may be related to the trophoblastic activity of the placenta [1]. Certain nuclear matrix proteins (NMPs) have also been identified as cancer specific markers among human colon, breast and bone cancer. They are detectable in voided urine [2]. Nuclear matrix protein 22 (NMP-22) has been shown to be a useful tumour marker for
T Corresponding author. Yenisehir Mh., Cumhuriyet Blv., Gunes Apt. B Blok, #14/18, 46100, Kahramanmaras/Turkey. Tel.: +90 344 221 23 37; fax: +90 344 221 23 71. E-mail address: [email protected] (M.A. Guven).
identifying recurrence of transitional cell carcinoma of the urinary tract [3]. However, its urinary level in pregnancy has not been investigated yet. Our aim was to investigate this latter issue. The urinary NMP-22 levels of 64 healthy pregnant women were measured at different gestational ages and 18 age matched non-pregnant healthy women in a spot morning urine sample using the commercially available NMP-22 test kit. Statistical analysis was performed using the Student’s T-test and Pearson’s two-tailed method. The results are given in meansFstandard deviation (S.D.). The age of pregnant women in the first, second, and third trimester and those of nonpregnant controls was (XFS.D.: meanFstandard deviation; range) 25.7F4.9 (20—37), 28.7F6.2 (20—42), 25.6F4.5 (18—35) and 27.9F5.8 (19— 37), respectively ( pN0.05). Urinary NMP-22 levels are shown at Table 1. There was also an increase of urinary NMP-22 with advancing gestational age ( pb0.01; Fig. 1). This is the first study showing that urinary NMP22 levels tend to increase with advancing gesta-
0020-7292/$ - see front matter D 2005 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.ijgo.2005.01.030
Urinary levels of nuclear matrix Table 1 group
139
Comparison of urinary NMP-22 values according to trimesters in healthy pregnant women and control
State
Non-pregnant control (n=18)
Pregnant women in the first trimester (n=20)
Pregnant women in the second trimester (n=21)
Pregnant women in the third trimester (n=23)
Mean urinary NMPFS.D. (U/ml) Range
2.30F1.38a,b
3.24F2.26c,d
5.42F2.4a,c,e
6.75F3.15b,d,e
0.24—4.98
0.27—9.80
0.89—9.51
0.73—12.66
a
Urinary NMP 22 (U/ml)
pb0.01, urinary NMP-22 level of patients in the second trimester compared with those in the first trimester and non-pregnant controls. b pb0.01, urinary NMP-22 level of patients in the third trimester compared with those in the first trimester and non-pregnant controls. c pb0.05, urinary NMP-22 level of patients in the second trimester compared with those in the first trimester and non-pregnant controls. d pb0.05, urinary NMP-22 level of patients in the third trimester compared with those in the first trimester and non-pregnant controls. e pN0.05, no significant difference was observed in the urinary levels of NMP-22 between patients in the second and third trimester.
8 6 4 2 0 Control group
1. Trimester
2. Trimester
3. Trimester
Figure 1 Comparison of urinary nuclear matrix protein 22 according to trimesters in healthy pregnant women and control group.
tional age. As only urinary NMP-22 concentrations were determined, however, no comment on concomitant blood levels can be made. As NMP-22 is normally secreted into the urine by transitional epithelium of the urinary tract, it is unlikely that it will be detectable in serum. This is further supported by studies showing that screening for urinary tract tumors of the urinary tract is only effective when performed in urine and not serum [2,3]. The increase of urinary NMP-22 in pregnancy is highly attributable to the increase in urinary output, as urinary output increases up to 50% beginning at the end of the first trimester [4]. The results presented here were obtained from healthy pregnant and non-pregnant women; therefore cut-off levels, which may aid in detecting urinary tract tumors, cannot be established. Further studies are needed to make clear statements about the sensitivity and specificity of
urinary NMP-22 determination as a screening tool in pregnancy.
References [1] Kobayashi F, Sagawa N, Nanbu Y, Nakamura K, Nonogaki M, Ban C, et al. Immunohistochemical localization and tissue levels of tumour-associated glycoproteins Ca 125 and Ca 19-9 in the decidua and fetal membranes at various gestational ages. Am J Obstet Gynecol 1989;160:1232 – 8. [2] Sawczuk IS, Lee B. The mechanism and clinical application of the NMP-22 tumour marker immunoassay: a review. Am Clin Lab 1999;18:24 – 6. [3] Carpinito GA, Stadler WM, Briggman JW, Chodak GW, Church PA, Lamm DL, et al. Urinary nuclear matrix protein as a marker for transitional cell carcinoma of the urinary tract. J Urol 1996;156:1280 – 5. [4] Dunlop W. Serial changes in renal haemodynamics during normal human pregnancy. Br J Obstet Gynaecol 1981;88:1 – 9.