Analysis of false-positive BTA stat test results in patients followed up for bladder cancer

• Published in: Urology (Ridgewood, N.J.) Vol. 57; no. 4; pp. 680 - 684
• Main Authors: Raitanen, Mika-P, Kaasinen, Eero, Lukkarinen, Olavi, Kauppinen, Risto, Viitanen, Jouko, Liukkonen, Tapani, Tammela, Teuvo L.J
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-04-2001; Elsevier Science
• Subjects: Adult; Aged; Aged, 80 and over; Antigens, Neoplasm - urine; Biological and medical sciences; Carcinoma, Transitional Cell - diagnosis; Carcinoma, Transitional Cell - urine; Cystoscopy; False Positive Reactions; Female; Follow-Up Studies; Humans; Male; Medical sciences; Middle Aged; Neoplasm Recurrence, Local - diagnosis; Neoplasm Recurrence, Local - urine; Neoplasm Staging; Nephrology. Urinary tract diseases; Prospective Studies; Sensitivity and Specificity; Tumors of the urinary system; Urinary Bladder Neoplasms - diagnosis; Urinary Bladder Neoplasms - urine; Urinary tract. Prostate gland; Urine - cytology; Human; Urine; Urinary system disease; Carcinoma; Cytology; Cystoscopy; Exploration; Tumoral marker; Malignant tumor; Urinary tract disease; Pathology; Urinary bladder; Bladder disease; Endoscopy; Diagnosis
• ISSN: 0090-4295; 1527-9995
• DOI: 10.1016/S0090-4295(00)01055-4

Objectives. To evaluate the role of a positive BTA
stat Test result in patients with negative cystoscopic findings.
Methods. Five hundred one consecutive patients in follow-up for bladder cancer were studied. A voided urine sample was obtained before cystoscopy and split for culture, cytology, and BTA
stat testing. In the case of a positive BTA
stat Test, but negative cystoscopic findings, patients underwent additional investigations.
Results. Of 501 patients, 133 (26.5%) had bladder cancer recurrence at cystoscopy, of which the BTA
stat Test detected 71 (53.4%); only 21 of the cases (17.9%) were detected by cytologic examination. Of the remaining 368 patients with no visible tumor at cystoscopy, 96 (26.1%) had a positive BTA
stat Test result. Fifty-five of those (57.3%) underwent intravenous urography or renal ultrasound and random biopsies, and an additional 9 recurrences (16.4%) were detected. Of those 46 patients who had a true false-positive BTA
stat Test, 3 (3 of 43, 7.0%) had recurrence at the next follow-up cystoscopy, 4 (8.7%) had a urine infection, and 8 (17.4%) had ongoing intravesical instillations; the latter two percentages were significantly higher than among those with true-negative BTA
stat Test results (0% and 6.8%, respectively).
Conclusions. Patients with a positive BTA
stat Test result but negative cystoscopic findings have about a 16% risk of an undetected recurrence. False-positive results may be due to present instillation treatment and urine infection, and the predictive value of a BTA
stat Test for subsequent recurrence seems relatively low.