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Title: Teste do BTA no diagnóstico do carcinoma de células de transição da bexiga
Other Titles: BTA test in the diagnosis of transi-tional cells carcinona of the bladder
Keywords: Neoplasia da bexiga-diagnóstico;  Carcinoma de células de transição-diagnóstico;  Teste de fixação do lá-tex;  Antígenos;  Antígenos de neoplasias.;  Neoplasia da bexiga urinária;  Carcinoma de células de transição;  Medicina;  Urologia
Issue Date: 30-Dec-1998
Abstract: We compared the Bard BTA test, which detects components of the basal membrane of the bladder epithelium in the voided urine, with filtration cytology for the diagnosis of transitional cell carcinoma (TCC) of the bladder. The study group was composed of 31 patients with TCC of bladder histologically confirmed and 70 without any tumor (con-trols). The mean age of the patients was 58 years old (range: 40 to 91 yr.). In the control group, 20 were absolutely normal and 50 had non-neoplastic genitourinary conditions [30 with benign prostatic hyperplasia (BPH) and 20 with nephrolithiasis]. For this group, the BTA test was performed with and without the addition of peripheral blood in the voided urine. The results showed that the BTA test was as sensitive as cy-tology for detection of TCC (71% vs 58%; p=0,075). However, it was less specific (84,3% vs 98,6%; p=0,01) and had a lower like-lihood ratio of positive results (4,52 vs 40,64). The positive pre-dictive value of the BTA test was lower than the cytology (66,6% vs 94,7%) and the presence of nephrolithiasis adversely affected its results (p=0,02). The presence of blood in the urine increased the number of false positives, but not at a statisti-cally significant level. Tumor grade, tumor stage, aspect and number of tumors, as well as the presence of BPH altered neither cytology nor the BTA test results. The chance of having a bladder TCC was 100% when both tests were positive, 75% with a positive cytology and a negative BTA test, 39% with a positive BTA test and a negative cytology and 9% when both tests were negative. We conclude that the BTA test does not substitute the cytol-ogy as a diagnostic tool for bladder TCC, but it can be used as an ancillary method for early and low-grade tumors.
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