Human complement factor H related protein test for monitoring bladder cancer

Citation
Mp. Raitanen et al., Human complement factor H related protein test for monitoring bladder cancer, J UROL, 165(2), 2001, pp. 374-377
Citations number
16
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Urology & Nephrology","da verificare
Journal title
JOURNAL OF UROLOGY
ISSN journal
0022-5347 → ACNP
Volume
165
Issue
2
Year of publication
2001
Pages
374 - 377
Database
ISI
SICI code
0022-5347(200102)165:2<374:HCFHRP>2.0.ZU;2-W
Abstract
Purpose: The BTA stat double dagger test is a rapid, noninvasive, qualitati ve urine test that detects bladder tumor associated antigen (human compleme nt factor H related protein) in wine. We compared BTA stat test to voided u rine cytology in patients monitored for bladder cancer in a prospective tri al, and determined whether this test is effective in detection of recurrenc e not seen by regular cystoscopy. Materials and Methods: A total of 445 consecutive patients with bladder can cer were studied. A voided urine sample was obtained before cystoscopy and divided for culture, cytology and BTA stat testing. In cases of a positive BTA stat test but negative cystoscopy, excretory urography or renal ultraso und, random biopsies and collected ureteral urine samples for ureteral cyto logy were obtained. The overall sensitivity and specificity as well as posi tive and negative predictive values for BTA stat test, cytology and their c ombination were calculated. Results: Of the 445 patients 118 (26.5%) had bladder cancer recurrence on c ystoscopy, which was detected by BTA stat test and cytology in 63 (53.4%) a nd 21 (17.8%), respectively. Of the remaining 327 patients not having recur rent tumor on cystoscopy 81 (24.8%) had a positive BTA stat test. Excretory urography or renal ultrasound and random biopsies in 48 (59.3%) of these p atients revealed 7 recurrences, making the total number of recurrent tumors 125 of 412 (30.3%). The overall sensitivities and specificities for the BT A stat test, cytology and their combination were 56.0%, 19.2%, 60.0% and 85 .7%, 98.3% and 85.0%, respectively. Conclusions: The sensitivity for detection of recurrent tumor on BTA stat t est is superior to that of voided urine cytology in all bladder cancer cate gories, whereas the specificity of voided urine cytology is higher than tha t for BTA stat test. However, a sixth of the patients with apparent false-p ositive BTA stat test results chosen for further investigation had recurren t tumors that were not found on routine cystoscopy. Although the sensitivit y and specificity were highest when both tests were used, the differences w ere not significant overall. Therefore, the BTA stat test could potentially replace urine cytology for followup of superficial bladder cancer.