title: Comparative evaluation of the BTAstat test, NMP22, and voided urine cytology in the detection of primary and recurrent bladder tumors.
abstract: OBJECTIVE
  This prospective study was undertaken to evaluate the diagnostic efficacy of the BTAstat test and nuclear matrix protein (NMP22) compared with voided urine cytology (VUC) in the detection of primary and recurrent bladder cancer.
  
  
  METHODS
  A total of 147 patients provided a single voided urine sample for the BTAstat test, NMP22, and cytology prior to cystoscopy. Eighty-five of them had no bladder cancer history, whereas the remaining 62 were monitored for superficial bladder cancer. A group of 21 healthy age-matched volunteers were also enrolled in the study.
  
  
  RESULTS
  Bladder cancer was confirmed histologically in 99 patients, of which 62 had primary tumors and 37 had recurrent ones. The overall sensitivity and specificity were 71.7% and 56.5% for the BTAstat test, 62.6% and 73. 9% for NMP22, and 38.4% and 94.2% for VUC. The optimal threshold value for NMP22 calculated with receiver operating characteristics curve, was 8 U/mL. BTAstat test was significantly more sensitive than VUC in detecting bladder cancer in all stage and grade subgroups, except GIII. On the contrary, NMP22 was significantly more sensitive than VUC only in stage Ta, grade I and II patients. BTAstat test had higher but not significantly different sensitivity than NMP22.
  
  
  CONCLUSIONS
  Our data indicate a superiority of both BTAstat test and NMP22 over VUC in the detection of bladder cancer. Comparing BTAstat test with NMP22, the former proved to be more sensitive, whereas the latter was more specific. Ruling out diseases with potential interference can increase the overall specificity of both tests. False-positive results of either test in patients followed up for bladder cancer seem to correspond to future recurrences.
authors.affiliation: Department of Urology, University of Athens Medical School, Athens, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Giannopoulos
authors.forename: T
authors.initials: T
authors.lastname: Manousakas
authors.forename: D
authors.initials: D
authors.lastname: Mitropoulos
authors.forename: E
authors.initials: E
authors.lastname: Botsoli-Stergiou
authors.forename: C
authors.initials: C
authors.lastname: Constantinides
authors.forename: M
authors.initials: M
authors.lastname: Giannopoulou
authors.forename: H
authors.initials: H
authors.lastname: Choremi-Papadopoulou
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000951:Antigens, Neoplasm / Q000032:analysis; D014408:Biomarkers, Tumor / Q000032:analysis*; D002295:Carcinoma, Transitional Cell / Q000175:diagnosis* / Q000276:immunology / Q000652:urine; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000276:immunology / Q000652:urine; D009367:Neoplasm Staging; D009687:Nuclear Proteins / Q000032:analysis*; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis* / Q000276:immunology / Q000652:urine; D014556:Urine / Q000166:cytology
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D009687:Nuclear Proteins; C112999:bladder tumor-associated antigen; C100379:nuclear matrix protein 22