Comparison of the bladder tumour antigen test with photodynamic diagnosis in patients with pathologically confirmed recurrent superficial urinary bladder tumours.
OBJECTIVE
To verify the sensitivity of the bladder tumour antigen (BTAstat, Bard Urological, Covington, GA) test against the sensitive procedure of photodynamic diagnosis (PDD), in which 5-aminolaevulinic acid (5-ALA, a precursor of fluorescent porphyrins) is absorbed by the tumour and detected by ultraviolet cystoscopy, in the early diagnosis of urinary bladder tumours.


METHODS
Forty-three patients (31 men and 12 women, age range 21-87 years) were assessed after transurethral resection of their bladder tumour using the BTAstat test and PDD. Sixty-nine biopsies from suspect areas of bladder mucosa were taken during cystoscopy under ultraviolet light and all suspect lesions electrocoagulated.


RESULTS
Thirty-five patients (81%) had a positive BTAstat test; in these patients PDD detected malignant lesions (17 Ta1G1-2, two T1G2, two T1G3 and 14 Tis). In eight patients (19%) the BTAstat was negative but PDD detected three malignant lesions (two Tis and one TaG1).


CONCLUSIONS
PDD is valuable for detecting bladder malignancy and can identify small lesions not detected by the BTAstat test.
Lipinski
M
M
Clinic of Urology, Medical University of Lodz, Pabianicka 62, 93-513 Lodz, Poland. miklipa@poczta.onet.pl
Jeromin
L
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000622:Aminolevulinic Acid; D000951:Antigens, Neoplasm / Q000032:analysis*; D014408:Biomarkers, Tumor / Q000032:analysis*; D003558:Cystoscopy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D017319:Photosensitizing Agents; D012680:Sensitivity and Specificity; D014466:Ultraviolet Rays; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis*
D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D017319:Photosensitizing Agents; C112999:bladder tumor-associated antigen; D000622:Aminolevulinic Acid