Bladder tumor antigen assay as compared to voided urine cytology in the diagnosis of bladder cancer

Background: The study was aimed at comparing the diagnostic accuracy of the quantitative bladder tumor antigen (BTA) TRAK (TM) immunoassay with exfoli ative urine cytology in the detection of primary and recurrent bladder canc er. Methods: The analysis was carried out on 194 high risk patients undergo ing a diagnostic cystoscopy, 279 patients with previous history of transiti onal cell carcinoma awaiting a follow-up cystoscopy, and 45 healthy control s. Urine cytology was performed by a skilled cytopathologist on three conse cutive samples. Results: BTA TRAK values resulted significantly higher in t umor positive cases than in absence of bladder tumor for both groups of pat ients. Non neoplastic urothelial diseases as well as the absence of mucosal abnormalities were associated with a marked increase in BTA TRAK levels wi th respect to the control group. Overall sensitivity and specificity was 63 and 63% for BTA TRAK (cut-off 34 U/ml), and 68.3 and 73.4% for urine cytol ogy, respectively. The diagnostic advantage of urine cytology was maintaine d when patients were stratified by tumor grade. Conclusions: The clinical p erformance of the BTA TRAK in the detection of primary or recurrent bladder cancer is acceptable and reproducible as shown by similar results with pre vious reports, although urine cytology performed on three samples showed th e highest sensitivity and specificity. (C) 2001 Elsevier Science B.V. All r ights reserved.