Influence of Gross or Microscopic Hematuria on BTA Stat Test Result in the Detection of Bladder Cancer

Abstract

Purpose: We prospectively evaluated the influence of gross or microscopic hematuria on the BTA stat test result in the detection of bladder cancer. Materials and Methods: Urinalysis, cytology and BTA stat test were performed simultaneously with the single voided fresh urine samples from 107 subjects in a blinded fashion. Subjects were divided into 4 groups according to the presence or absence of gross or microscopic hematuria and the influence of hematuria on the result of BTA stat test was evaluated. The sensitivity and specificity of the BTA stat test were compared to those of urine cytology. Results: Overall sensitivity and specificity of BTA stat test for the detection of bladder cancer were 74.1% and 51.3%, respectively and those of urine cytology were 37% and 100%, respectively. In patients with genitourinary disease other than bladder cancer, false-positive rate of BTA stat test was 50%. In patients without bladder cancer but with gross hematuria, false-positive rate of BTA stat test was 71.4%. On univariate analysis gross hematuria and the presence of bladder cancer affected the BTA stat test result significantly. However, on multivariate analysis the presence of gross hematuria only affected the BTA stat test result significantly. Conclusions: The BTA stat test was more sensitive but less specific than voided urine cytology and had a high false-positive rate, especially in cases with gross hematuria. These results offset the advantages of the BTA stat test in the detection of bladder cancer.