膀胱内灌注对人补体因子H相关蛋白（BTA stat）检测的影响。

Effect of intravesical instillations on the human complement factor H related protein (BTA stat) test.

作者信息

Raitanen M P, Hellström P, Marttila T, Korhonen H, Talja M, Ervasti J, Tammela T L

机构信息

Division of Urology, Tampere University Hospital, Tampere, Finland.

出版信息

Eur Urol. 2001 Oct;40(4):422-6. doi: 10.1159/000049810.

DOI:10.1159/000049810

PMID:11713397

Abstract

OBJECTIVES

The BTA stat is a rapid, non-invasive, qualitative urine test that detects bladder tumor-associated antigen (human complement factor H related protein) in urine. The sensitivity of this test is superior to that of urine cytology in detecting primary and recurrent tumors of the urinary bladder. Intravesical instillations are widely used to avoid recurrences and even progression. The objective of this study was to evaluate the effect of intravesical treatments on the BTA stat Test.

METHODS

501 consecutive patients followed up for bladder cancer were studied, of which 490 were eligible for analysis. Three hundred and twenty-seven (66.7%) of the patients had no history of intravesical treatments, whereas the remaining 163 (33.3%) had received treatments: 66 (40.5%) at the time of evaluation. A voided urine sample was obtained prior to cystoscopy and split for culture and BTA stat testing. The overall sensitivity and specificity were calculated and compared to the patients with no, past and present instillations.

RESULTS

The overall sensitivity for the BTA stat Test was 56.6%, and the specificity was 76.4%. The specificity of the BTA stat Test was 80.7, 70.7 and 65.3% in those with no, past or present intravesical instillation treatments, respectively. The difference in specificity between those with no and present instillations was significant (p = 0.023), whereas the notable difference between those with no and past instillations did not reach significance (p = 0.076), nor was the difference between patients with past and present instillations significant (p = 0.558). Present instillation of mitomycin C had the strongest adverse effect on the test as the specificity was only 25.0%, whereas past treatment did not interfere with testing. The adverse effect of BCG treatment on testing extended.

CONCLUSION

The overall specificity of the test is decreased in patients receiving intravesical treatments, whereas past treatments did not interfere with testing in general. However, the adverse effect of BCG on testing seems to extend, and therefore it is suggested that the BTA stat Test should not be used in patients having received BCG, and in those with present instillation of any type.

摘要

目的

BTA stat是一种快速、非侵入性的定性尿液检测方法，可检测尿液中的膀胱肿瘤相关抗原（人补体因子H相关蛋白）。该检测在检测膀胱原发性和复发性肿瘤方面的敏感性优于尿液细胞学检查。膀胱内灌注广泛用于避免复发甚至进展。本研究的目的是评估膀胱内治疗对BTA stat检测的影响。

方法

对501例连续随访的膀胱癌患者进行研究，其中490例符合分析条件。327例（66.7%）患者无膀胱内治疗史，其余163例（33.3%）接受过治疗：66例（40.5%）在评估时接受治疗。在膀胱镜检查前获取一次晨尿样本，分为两份分别进行培养和BTA stat检测。计算总体敏感性和特异性，并与未接受过、过去接受过和目前正在接受灌注治疗的患者进行比较。

结果

BTA stat检测的总体敏感性为56.6%，特异性为76.4%。在未接受过、过去接受过或目前正在接受膀胱内灌注治疗的患者中，BTA stat检测的特异性分别为80.7%、70.7%和65.3%。未接受过和目前正在接受灌注治疗的患者之间特异性差异有统计学意义（p = 0.023），而未接受过和过去接受过灌注治疗的患者之间差异无统计学意义（p = 0.076），过去接受过和目前正在接受灌注治疗的患者之间差异也无统计学意义（p = 0.558）。目前灌注丝裂霉素C对检测的不良影响最强，特异性仅为25.0%，而过去的治疗不影响检测。卡介苗治疗对检测的不良影响持续存在。