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KMID : 0857020020170010048
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Kosin Medical Journal
2002 Volume.17 No. 1 p.48 ~ p.53
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The Bladder Tumor Antigen(BTA) Stat Test Compared to Voided Urine Cytology in the Detection of Bladder Cancer
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Koo Ja-Whan
Lee Chang-Kyu
Rhew Hyun-Yul
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Abstract
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Purpose : We assessed the sensitivity and specificity of the noninvasive BTA stat test for detection of bladder cancer with special reference to the grades and stages of the tumors.
Materials and Methods : A total of 163 patients provided voided urine samples for the BTA stat test and cytopathological study. Each patient underwent cystoscopy. Transurethral resections were performed when a bladder tumor was seen or cystoscopic biopsies were obtained when a carcinoma in situ was suspected. Sensitivity was determined using voided urine samples from patients with histologically proven bladder cancer (n=125). Specificity was determined from patients with benign urologic disease (n=40), healthy volunteers (KTP donor, n=20), malignant urologic cancer other than bladder (n=18), non-urologic malignancy (n=2), and patients, with a history of bladder cancer but free of disease (n=24). The sensitivity and specificity of BTA stat test were compared to those of standard voided urine cytology, and the sensitivities of BTA stat test and urine cytology were stratified according to histologic grades and stages.
Results : Overall sensitivity of the BTA stat test and urine cytology were 86.6% and 45.2% specificity were 72.3% and 97.3% respectively. For each histologic grade of transitional cell carcinoma (grade 1, 2, 3, 4), sensitivity was 36.4%, 84.1%, 87.2% and 91.3% for BTA stat test, and 18.2%, 13.6%, 53.2% and 82.6% for urine cytology, respectively. For each stage of transitional cell carcinoma (stage Ta, T1 > T2), sensitivity was 50%, 81.5% and 98.4% for BTA stat test, and 0%, 5.6% and 75.4% for urine cytology, respectively. The false positive of BTA stat test was seen in patients with gross hematuria, urinary tract infection, urologic malignancy other than bladder cancer and benign prostatic hyperplasia.
Conclusion : BTA stat test is a simple, non-invasive, inexpensive adjunct to cystoscopy with urine cytology. In our study the BTA stat test was clinically reliable in the diagnosis for bladder cancer, and can be used as a screening test for bladder cancer in patients with hematuria or irritative voiding symptoms.
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KEYWORD
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Bladder cancer, BTA stat test, Urine cytology
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