Usefulness of the BTA test in the detection of bladder cancer

Objectives: To compare usefulness of Bard's(R) BTA(R) test and urine cytolo gy in the diagnosis of bladder cancer. Patients and methods: Voided urine samples taken from 91 patients clinicall y diagnosed of bladder cancer and of 22 control patients were split for BTA (R) testing, cytology and urinary sediment. Afterwards, patients with bladd er cancer underwent transurethral resection of bladder lesions, multiple ra ndom cold cup biopsies of the bladder mucosa and biopsies of the prostatic urethra with resectoscope. Results: Sensitivity of BTA(R) testing and urine cytology in the 91 patient s with bladder cancer was 78% and 59.3% respectively (p=0.004). The associa ted use of both tests increased the sensitivity up to 85.7 %. The combincat ion of BTA(R) test, urinary cytology and urinary sediment yielded a sensiti vity of 95.6%. The BTA(R) test proved to be more sensitive than voided cyto logy in the detection of TaG1-G2 tumors (63.3% versus 33.3%; p < 0.05) and TaG3-T1 G2-G3 tumors (86.7% versus 60%: p < 0.05). Nevertheless, cytology s eemed to more sensitive than the BTA(R) test in detecting bladder carcinoma s in situ (Cis). The specificity of the BTA(R) test was remarkably lower th an that of cytology (p < 0.05) in control patients suffering from inflammat ory disorders of the bladder or bladder lithiasis. Conclusion: The BTA(R) test was superior to voided urine cytology for the d etection of superficial bladder tumors. Cytology however seemed to be super ior at detecting carcinoma in situ. The combination of BTA(R), urinary sedi ment and cytology yielded the highest sensitivity.