The Clinical Utility of BTA TRAK, BTA stat, NMP22 and Urine Cytology in the Diagnosis of Bladder Cancer: A Comparative Study

Kwon, Duk Hyung; Hong, Sung Joon

Abstract

PURPOSE: Various tumor markers, developed recently for the diagnosis of bladder cancer, are reported to be superior to urine cytology in terms of their sensitivity and non-invasiveness. A prospective study was performed to evaluate the efficacies of BTA TRAK, BTA stat, NMP22 tests and urine cytology.
MATERIALS AND METHODS
Between August 2001 and December 2001, 154 patients were involved in the study. Voided urine was used to perform BTA TRAK, BTA stat, NMP22 tests and cytology. The final diagnoses were pathologically proven transitional cell carcinoma (TCCa) of the bladder in 34 patients, gross or microscopic hematuria without detectable tumor in 27, history of TCCa without evidence of recurrence in 68 and benign urologic diseases in 25.
RESULTS
The sensitivities of the BTA TRAK, BTA stat, NMP22 and urine cytology were 82.4, 79.4, 61.8 and 32.4%, respectively. The specificities were 75.8, 70.8, 95.8 and 92.5%, respectively. When the sensitivity was subdivided according to the tumor stage, grade and size, the bigger size yielded higher sensitivities in the NMP22 and BTA TRAK (p<0.01 and p=0.03, respectively). When the results of the urine cytology were combined with each of the other tests, the specificity was lower than each test alone for the BTA TRAK and BTA stat, while sensitivity and specificity were both higher than each test alone for the NMP22.
CONCLUSIONS
The BTA TRAK, BTA stat and NMP22 tests are useful in overcoming the limitations of cystoscopy and cytology as the initial evaluation tools for patients where bladder cancer is suspected. In particular, the NMP22 may be more useful due to its enhanced specificity when combined with the urine cytology.