Evaluation of the Bard BTA-test in the diagnosis of upper urinary tract tumours.

The BTA-test is an agglutination assay that qualitatively detects the presence of complexes of basement membrane within the urine of patients with bladder cancer. However, the significance of BTA test in other urotelial tumours has not been extensively studied. Therefore, in the present research, we examined the validity of BTA-test in patients suffering from ureteral or renal pelvis cancer, and compare results with urincitology. 35 patients were included in this study (13 with ureteral and 22 with renal pelvis cancer). BTA-test and urincitology in each patient was performed on two urine specimens: morning voiding urine and separate urine. Separate urine was obtained by means of ureteral catheter. The results of BTA test were compared with urine cytology. All patients udervent routine clinical examination (biochemical analysis, ultrasonography, i.v. urography and retrograde urography). The presence of urothelial carcinoma was histopatologically proved in all cases. 35 patients with renal calculosis without malignancy were control group. Separate and voided urine was taken for examination with BTA test and urincitology from all these patients. BTA test in urine specimen obtained by ureteral catheter were positive in 22 (62.9 %) patients and in complete urine in 18 (51,4%) patients. Urine cytology was positive in 20 (57,1%) separate urine specimen and in complete urine in 17 (48.6%) patients. Characteristics of each patient, clinical findings and patohystology findings take places in statistic evaluation of the results. The sensitivity of BTA test depends directly on histopatology characteristics of tumours. Tumours with high grade and high stage more often have positive resuIts of test and urincitology. The test had the highest sensitivity among the group of high risk patients, with T2, T3, T4 stadium, 77,8% in separate urine and 61.11% in voided urine with specificity of 80% for separate urine and 85.71% for voided urine. Sensitivity for cytology in the same group was 72,22% for separate and 55,56% for voided urine, with specificity of 97,14% in both specimens. Based on the obtained results, we can conclude that simple and rapid BTA test can have significant position in the diagnostics of upper urinary tract tumours, but we still have to search for an ideal tumour marker for transitional cell carcinoma of upper urinary tract.