Purpose: To assess the role of NMP22 and cytology in diagnosing primary and recurrent bladder cancer and to compare the sensitivity, specificity, positive and negative predictive values, accuracy by means of staging, grading, dimensions and the number of the tumours.

Material and Method: A total of 153 patients (sixty one with bladder cancer) were included. Urine specimens were collected for cytology and NMP22 before sistoscopy.

Results: A sensitivity of 65.6%, specificity of 53.2%, PPV of 51.9%, NPV of 66.7% and an accuracy rate of 58.6% was obtained with NMP22 whereas a sensitivity of 36.1%, specificity of 96.2%, PPV of 88%, NPV of 66.1% and an accuracy rate of 70% was obtained with cytology. Cut-off value which NMP22 has the optimal sensitivity and sensitivity was determined 14.2 U/ml with the help of ROC analysis. The sensitivity of NMP22 was higher. Cytology had higher specificity and PPV. When evaluated together, an increase in sensitivity and in PPV, and a decrease in NPV and in accuracy rate was obtained with no change in specificity. NMP22 was higher both in the group with bladder carcinomas and in the group with benign urological complaints than healthy controls in a significant manner. No significant relationship was found between NMP22 and the grade, stage and the number of tumour. Significant relationship was found between grade II and grade III tumours by means of NMP22. No statistically significant relationship was found between the cytology and the grade, stage, tumour size and the number of tumour.

Conclusion: NMP22 is more sensitive and less dependent on the applicant than cytology. NMP22 has the disadvantages of being less specific and having a lower PPV. It is always preferred to have a false positive result with an additional cystoscopy rather than to overlook a tumour. NMP22 is more useful than cytology but it can not be an alternative to cystoscopy.