Comparison of two qualitative assays, the UBC rapid test and the BTA stat test, in the diagnosis of urothelial cell carcinoma of the bladder

Objectives. To compare the diagnostic value of two rapid tests, the bladder tumor antigen (BTA stat) test and the newly developed urinary bladder canc er (UBC) Rapid test, in patients having symptoms suggestive of urothelial c ell carcinoma (UCC) and patients being followed up after transurethral rese ction. Methods. One hundred eighty patients with a mean age of 65.8 years (range 2 2 to 92) were included in the present study. The tests were performed on vo ided urine samples, Fifty-seven patients had symptoms suggestive of UCC and 123 patients were being followed up after complete transurethral resection of UCC. The voided urine was evaluated by the BTA stat and UBC Rapid test, which detects cytokeratins 8 and 18. All patients underwent subsequent cys toscopic evaluation and biopsy of any suspicious lesion. Results. In 53 patients with histologically proved UCC, the BTA stat had a sensitivity of 52.8% and the UBC Rapid test of 66%. According to the histol ogic stage, the sensitivity of the BTA stat was 42.8% in pTa tumors, 61.5% in pT1, and 70% in pT2 or higher tumors. The sensitivity of the UBC test wa s 60.7% in pTa, 69.2% in pT1, and 80% in pT2 or higher tumors. For histolog ic grades 1 to 3, the sensitivity was 38.8%, 52.6%, and 68.7% for the BTA s tat and 44.4%, 78.9%, and 75% for the UBC Rapid test, respectively. The spe cificity was 70% and 90% for the BTA stat and UBC Rapid test, respectively. Conclusions, The UBC Rapid test was superior to the BTA stat in both sensit ivity and specificity. Both assays are simple office procedures and require no special knowledge. However, they cannot replace, but only lower, the nu mber of cystoscopies during the follow-up of patients with previous UCC of the bladder. UROLOGY 56: 228-231, 2000. (C) 2000, Elsevier Science Inc.