Comparison of the Bard BTA Stat Test and Cytology in the Diagnosis and Follow-up of Bladder Cancer

Jeong, Young Beom; Kim, Hyung Jin

Abstract

PURPOSE: The BTA stat test is a one-step immunochromatographic assay to detect bladder tumor antigen in the urine. We evaluated the efficacy of the BTA stat test and bladder wash cytology(BWC) in the detection and follow-up of bladder cancer.
MATERIALS AND METHODS
A voided urine sample for BTA stat test and bladder washing urine for cytology were obtained. The BTA stat test with or without BWC was performed in normal volunteers(n=20), patients with hematuria of unknown origin(n=29), patients with benign genitourinary(GU) disease(n=17), patients with other GU cancer(n=12), patients with bladder cancer(n=46) and patients with a history of bladder cancer(n=54).
RESULTS
The overall sensitivities of the BTA stat and BWC in bladder cancer were 69.6% and 41.3%, respectively(p<0.01). For T2 or higher stage tumors, sensitivity was 94.1% for BTA stat and 64.7% for BWC(p<0.05). Grade II tumors were detected at 64.3% with BTA stat and 35.7% with BWC(p<0.05). The sensitivities of the BTA stat and BWC in the follow-up of patients after transurethral resection of bladder tumor were 45.5%(5/11) and 27.3% (3/11), respectively. The specificities of the BTA stat and BWC in the same patients were 88.4%(38/43) and 100%(43/43), respectively(p<0.05). The specificity in patients with hematuria but without disease was 69% for BTA stat and 100% for BWC. The specificities of the BTA stat in healthy volunteers, benign GU disease and other GU cancer were 95%, 82.4% and 75%, respectively.
CONCLUSIONS
Our results demonstrate that BTA stat test is a simple, noninvasive test that is superior to bladder wash cytology for detection of bladder cancer in its sensitivity and a useful adjunct of cystoscopy in surveillance and diagnosis of bladder cancer. However, the BTA stat test can not replace cystoscopy due to low specificity.