Clinical performance and utility of a NNMT-based urine test for bladder cancer



Bladder cancer (BC) represents the most common neoplasm of the urinary tract. Although cystoscopy and urine cytology represent the gold standard methods to monitor BC, both procedures have limitations. Therefore, the identification of reliable biomarkers for early and noninvasive detection of BC is urgently required.


In this study, we analyzed nicotinamide N-methyltransferase (NNMT) expression in urine samples from 55 BC patients and 107 controls, using real-time polymerase chain reaction (PCR). Receiver operating characteristic (ROC) analysis was used to identify the best cutoff value to discriminate BC patients from healthy donors, and to evaluate the diagnostic accuracy of a urine-based NNMT test.


The results demonstrated that urinary NNMT expression was significantly (p<0.05) higher in BC patients. Moreover, a significant (p<0.05) inverse correlation was found between NNMT expression and histological grade. The ROC analysis revealed that a ΔCq of 13.3 was the best cutoff value, since it was associated with the highest combination of sensitivity and specificity. Moreover, the area under the curve (AUC) value was 0.913 (p<0.05), indicating the excellent diagnostic accuracy of a urine-based NNMT test.


Our data indicate that NNMT is a promising biomarker that could be used to support the early and noninvasive diagnosis of BC.

Post author correction


Article Subject: Diagnostic Biomarkers



Valentina Pozzi, Giulia Di Ruscio, Davide Sartini, Roberto Campagna, Riccardo Seta, Paola Fulvi, Alexia Vici, Giulio Milanese, Gabriele Brandoni, Andrea B. Galosi, Rodolfo Montironi, Monia Cecati, Monica Emanuelli

Article History


Financial support: This work was partially supported by Infinito Vita SMS (Recanati, Italy), and a fellowship (D.S.) was sponsored by the Fondazione Umberto Veronesi.
Conflict of interest: The authors declare they have no competing interests.

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  • Department of Clinical Sciences, Polytechnic University of Marche, Ancona - Italy
  • New York–Marche Structural Biology Center (NY-MaSBiC), Polytechnic University of Marche, Ancona - Italy
  • Infinito Vita SMS, Recanati - Italy
  • Department of Biomedical Sciences and Public Health, Polytechnic University of Marche, Ancona - Italy
  • Valentina Pozzi and Giulia Di Ruscio contributed equally to this work.

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