A Comparison of BTA stat and NMP 22 as Non-Invasive Screening Methods for Bladder Cancer. A Systematic Review.

BackgroundThe purpose of this study was to systematically review the effects of bladder tumor antigen (BTA) stat and nuclear matrix protein (NMP) 22 as a screening method in an asymptomatic population. Methods We evaluated 381 international studies by selecting randomized controlled trials (RCTs). We descriptively evaluated and summarized all of the 381 studies to identify their strengths and weaknesses in terms of the use of BTA stat and NMP 22. ResultsWe did not identify any RCTs that used BTA stat or NMP 22 as a pure screening tools. We also did not identify any studies that used an asymptomatic population. Different cut-off values and individualized methods were discussed for NMP 22 based on age, sex, risk factors, and history of bladder cancer, introducing significant heterogeneity and bias. Interestingly, the use of NMP 22 demonstrated only in men younger than 65 years positive results. ConclusionsRCTs are needed to show a reliable sensitivity and specificity of using BTA stat or NMP 22 as a screening test. It may be worth investigating in future studies whether it would be useful to offer NMP 22 to only a certain profile of patients. Based on our findings and in consent with national and international guidelines, a screening recommendation using NMP 22 and/or BTA stat can not be given for bladder cancer in an asymptomatic population.

The influence of haematuria on the utility of the BTA stat test in the diagnosis of bladder cancer: a prospective study

Background The urinary bladder tumour antigen (BTA) stat test has already been used for the diagnosis and monitoring of bladder cancer (BC). However, more evidence is needed regarding its efficacy and utility in the clinic. In this study, we investigated the influence of haematuria on the performance of the BTA stat test in a clinical cohort.Methods Urine samples from 836 subjects, including 50 healthy volunteers, 553 patients with benign urologic disorders, 124 patients with histologically proven BC, and 109 patients with other histologically proven urologic cancers, were analysed by the BTA stat test and urinalysis. We detected the sensitivity and specificity of the BTA stat test in each group and analysed the effect of haematuria on the specificity.Results Our data show that 58.06% of patients in the BC group had haematuria. Haematuria with benign prostatic hyperplasia (BPH), renal hamartoma (RH) and urolithiasis were identified in 39.01%, 42.86% and 66.49% of patients with benign urologic disorders, respectively. Haematuria was identified in 48.72% of prostatic cancer patients and 67.74% of renal cancer patients. The overall sensitivity of the BTA stat test was 90.32%. The sensitivity was 97.22% in BC patients with haematuria and 80.77% in BC patients without haematuria. The overall specificity in healthy individuals, patients with benign urologic disorders and patients with other urologic cancers was 50.84%. In all patients with haematuria, the specificity of the BTA stat test was 15.82%, while the specificity was 72.6% in patients without haematuria.Conclusions Haematuria has a significant influence on the BTA stat test. The performance of the BTA stat test can be increased if patients with known or obvious haematuria conditions are excluded from the test.

The influence of haematuria on the utility of the BTA stat test in the diagnosis of bladder cancer: a prospective study

Background: The urinary bladder tumour antigen (BTA) stat test has already been used for the diagnosis and monitoring of bladder cancer (BC). However, more evidence is needed regarding its efficacy and utility in the clinic. In this study, we investigated the influence of haematuria on the performance of the BTA stat test in a clinical cohort. Methods: Urine samples from 836 subjects, including 50 healthy volunteers, 553 patients with benign urologic disorders, 124 patients with histologically proven BC, and 109 patients with other histologically proven urologic cancers, were analysed by the BTA stat test and urinalysis. We detected the sensitivity and specificity of the BTA stat test in each group, and analysed the effect of haematuria on the specificity. Results: Our data showed that 58.06% of patients had haematuria in the BC group. Haematuria with benign prostatic hyperplasia (BPH), renal hamartoma (RH) and urolithiasis were identified in 39.01%, 42.86% and 66.49% of patients with benign urologic disorders, respectively. Haematuria was identified in 48.72% of prostatic cancer patients and 67.74% of renal cancer patients. The overall sensitivity of the BTA stat test was 90.32%. The sensitivity was 97.22% in BC patients with haematuria and 80.77% in BC patients without haematuria. The overall specificity in healthy individuals, patients with benign urologic disorders and other urologic cancers was 50.84%. In all patients with haematuria, the specificity of the BTA stat test was 15.82%, while it was 72.6% in patients without haematuria. Conclusions: Haematuria has a significant influence on the BTA stat test. Thus, this test should not be used for the diagnosis of bladder cancer in patients with haematuria.

Interference From Haematuria Renders the Urinary BTA Test Not Specific Enough for Diagnosing Bladder Cancer: Evidence From Clinical Practice

Background The urinary bladder tumour antigen (BTA) stat test has already been used for the diagnosis and monitoring of bladder cancer (BC). However, more evidence is needed regarding its efficacy and utility in the clinic. In this study, we investigated the influence of haematuria on the performance of the BTA stat test in a clinical cohort.Methods Urine samples from 836 subjects, including 50 healthy volunteers, 553 patients with benign urologic disorders, 124 patients with histologically proven BC, and 109 patients with other histologically proven urologic cancers, were analysed by the BTA stat test and urinalysis. We detected the sensitivity and specificity of the BTA stat test in each group, and analysed the effect of haematuria on the specificity.Results Our data showed that 58.06% of patients had haematuria in the BC group. Haematuria with benign prostatic hyperplasia (BPH), renal hamartoma (RH) and urolithiasis were identified in 39.01%, 42.86% and 66.49% of patients with benign urologic disorders, respectively. Haematuria was identified in 48.72% of prostatic cancer patients and 67.74% of renal cancer patients. The overall sensitivity of the BTA stat test was 90.32%. The sensitivity was 97.22% in BC patients with haematuria and 80.77% in BC patients without haematuria. The overall specificity in healthy individuals, patients with benign urologic disorders and other urologic cancers was 50.84%. In all patients with haematuria, the specificity of the BTA stat test was 15.82%, while it was 72.6% in patients without haematuria.Conclusions Haematuria has a significant influence on the BTA stat test. Our study suggested that the BTA stat test is not an ideal diagnostic tool for BC.

Bladder tumour antigen (BTA stat) test compared to the urine cytology in the diagnosis of bladder cancer: A meta-analysis

Introduction: We evaluate the diagnostic value of bladder tumour antigen (BTA stat) tests compared with urine cytology test in detecting bladder cancer.Methods: We searched public databases including PubMed, MEDLINE Springer, Elsevier Science Direct, Cochrane Library and Google Scholar before December 2012. To collect relevant data of BTA stat tests and urine cytology tests in patients with bladder cancer, we studied meta-analyses of sensitivity, specificity, positive likelihood ratio (LR), negative LR and diagnostic odds ratios (DOR) of BTA stat tests and cytology tests from published studies. We applied the software of Rev. Man 5.1 and Stata 11.0 to the meta-analysis.Results: A total of 13 separate studies consisting of 3462 patients with bladder cancer were considered in the meta-analysis. We found that the BTA stat test had a higher sensitivity than the urine cytology test (0.67, 95% confidence interval [CI] 0.64 to 0.69 vs. 0.43, 95% CI 0.40 to 0.46), but the specificity, positive LR, negative LR, DOR, the area under the curve (AUC) and Q index of the BTA stat test were lower compared with the urine cytology test. The results of the Egger’s linear regression test showed no publication bias (p > 0.05).Conclusions: Specificity, positive LR, negative LR, DOR, the AUC and the Q index of the urine cytology test may be superior to the BTA stat test, but the BTA stat test has greater sensitivity than the urine cytology test.