The Role of Urine BTA-TRAKTM and Cytology Tests for Follow-Up of Superficial Bladder Transitional Cell Carcinoma

尿液BTA-TRAKTM 及尿液細胞學檢查在追踨表淺性膀胱移形上皮癌之角色

薛又仁(Thomas Y. Hsueh) ； 邱文祥(Allen W. Chiu) ； 黃于倫(Yu-Lun Huang) ； 黃冠華(Steven K. Huan) ； 鄭哲舟(Tse-Chou Cheng) ； 沈坤宏(Kun-Hung Shen) ； 林嘉祥(Victor C. Lin) ； 王毓君(Yu-Chun Wang) ； 朱志峰(Jyh-Phen Ju) ； 林靖南(Ching-Nan Lin)

《臺灣泌尿科醫學會雜誌》 14卷1期 (2003/03) Pp. 1-5

摘要

研究目的：BTA-TRAKTM是一種利用尿液檢驗膀胱移形上皮癌的免疫檢查法。此實驗乃在於BTA-TRAKTM與尿液細胞學檢查對罹患膀胱移形上皮癌的病人追踨之結果。
材料與方法：一共有107位病患加入此實驗。對於這些病患，每三個月收集尿液，並分別進行尿液細胞學與BTA-TRAKTM之檢查。一旦尿液細胞學或是BTA-TRAKTM有陽性反應，立即為這些病患進行膀胱鏡檢查。但若尿液細胞與BTA-TRAKTM均為陰性反應，則不進行膀胱鏡檢查。在距病患收集第一次尿液的六個月之後，為這些病患進行膀胱鏡檢查，並作為實驗終止之時間點。
結果：對於BTA-TRAKTM，其敏感性與特異性分別為80%與86.9%。其正向預估值為0.5，而反向預估值為0.964。對於尿液細胞學檢查，其每感性為46.7%，而特異性為97.8%。其正向預估為0.777，而反向預估值為0.918。在66位尿液細胞學與BTA-TRAKTM均為陰性反應之病患中，其6個月的追踨結果均無膀胱移形上皮癌復發的現象。
結論：單獨的BTA-TRAKTM與尿液細胞學的結果均不足以取代膀胱鏡檢查，但是，如果尿液細胞學與BTA-TRAKTM的檢查結果均為陰性，則膀胱鏡追踨檢查可暫時性的在6個月內不需進行。

關鍵字

膀胱癌 ； 膀胱移形上皮癌 ； BTA檢查 ； 尿液細胞學檢查

並列摘要

OBJECTIVES: The BTA-TRAKTM test is an immunologic test for detecting bladder transitional cell cancer (TCC) in urine. This study aimed to evaluate the role of the BTA-TRAKTM test and voided urine cytology for surveillance of patients with bladder TCC.
MATERIALS AND METHODS: In total, 107 patients were enrolled in this study. Results of voided urine cytology and the BTA-TRAKTM test were obtained every 3 months. Cystoscopy was performed when a positive result of either voided urine cytology or BTA-TRAKTM was found. No cystoscopy was done if both tests were negative. The end-point of the surveillance consisted of a routine cystoscopic examination for every patient at 6 months after the first collection of urine.
RESULTS: The sensitivity and specificity of BTA-TRAKTM test were 80.0% and 86.9%, respectively. The positive predictive value of the BTA-TRAKTM test was 0.5, while the negative predictive value was 0.964. The sensitivity and specificity of voided urine cytology were 46.7% and 97.8%, respectively. The positive predictive value of voided urine cytology was 0.777, while the negative predictive value was 0.918. None of the 66 patients with negative results for both cytology and the BTA-TRAKTM test developed recurrence by 6 months later.
CONCLUSIONS: The predictive value of either BTA-TRAKTM or cytology was not sufficiently good to be a substitute for cystoscopy. However, follow-up cystoscopy may be temporarily postponed for a period of 6 month if both tests are negative.

並列關鍵字

bladder transitional cell carcinoma ； BTA test ； urine cytology