Impact of a radical prostatectomy on the urodynamic results of prostate cancer patients treated with intensity modulated radiation therapy.

INTRODUCTION AND OBJECTIVES: To evaluate the effect of radical prostatectomy and age on urodynamics before and after intensity-modulated radiation therapy administered to prostate cancer patients. MATERIALS AND METHODS: The sample consisted of 40 prostate cancer patients, 22 of whom had undergone a radical prostatectomy. Urodynamic parameters before and after an average of 4.2 months of radiotherapy were measured and compared. External radiotherapy was administered via Volumetric Modulated Arc Therapy (VMAT), Intensity Modulated Radiation Therapy (IMRT) techniques. RESULTS: Uroflowmetry presented no significant parameters. In the case of Cystomanometry, the data did not show an increase in secondary stress urinary incontinence, although there is 7 percent increase in urge urinary incontinence. There were statistically significant changes in reduced bladder capacity with a strong desire to void, with an urge to void and also in the detrusor pressure with a normal desire to void. Furthermore, pressure/flow analysis revealed a statistically significant reduction of residual urine volume. CONCLUSIONS: The effect of prostatectomy and age varies according to the evolution of urodynamics. There was a significant reduction in terms of residual urine volume and detrusor pressure with a normal desire to void in patients without a prostatectomy and in those under 75 years old. In addition to an increase in urge incontinence, there was also a significant worsening of the bladder filling urodynamics and a decrease in the cystomanometric bladder capacity with a strong desire and an urge to void. None of these were modified by age or prostatectomy.

[Interpretation of the metabolic study in renal lithiasis and its treatment]. / Interpretación del estudio metabólico en la litiasis renal y su tratamiento.

Urolithiasis is a common disease, and is an important health problem that is associated with a great economic burden. The nature of stone disease varies according by dietary and lifestyle factors, including, among others, climate variations. The majority of patients will suffer a new lithiasic episode at some point in their life, unless preventive measures, such as changing lifestyles and dietary habits, are put in place to avoid it. The risk factors involved in lithogenesis should be evaluated in order to reduce recurrences. In the majority of these patients, metabolic changes are observed in the urine that predispose lithogenesis. The kind of evaluation depends on stone composition and on the clinical presentation. A diagnosis of systemic and renal diseases of lithogenic nature can be diagnosed with these studies, and they also enable the adoption of precise prophylactic measures that achieve control of recurrence in a great number of patients.

Comparative analysis of the expression of metalloproteases (MMP-2, MMP-9, MMP-11 and MMP-13) and the tissue inhibitor of metalloprotease 3 (TIMP-3) between previous negative biopsies and radical prostatectomies. / Análisis comparativo de la expresión de metaloproteasas (MMP-2, MMP-9, MMP-11 y MMP-13) y del inhibidor tisular de la metaloproteasa 3 (TIMP-3) entre las biopsias previas negativas y las prostatectomías radicales.

Metalloproteases (MMPs) and tissue inhibitor of metalloprotease-3 (TIMP-3) have been associated to the risk of having cancer and tumor aggressiveness. When facing the difficulties of prostate cancer diagnosis, the expression of MMPs and TIMP-3 in negative biopsies could be helpful to evaluate a diagnostic suspicion. Our objective is to carry out a comparative study of the expression of MMPs and TIMP-3 in previous negative biopsies and radical prostatectomies (RP). MATERIAL AND METHODS: Retrospective analysis of a hospital-based cohort including 21 patients with suspicion of prostate carcinoma, whose expressions of MMP-2, 9, 11 and 13 and TIMP-3 were evaluated by immunohistochemistry in the tumor area from previous negative biopsies and RP. RESULTS: Immunohistochemical staining values (Score) for MMPs (-11 and -13) and TIMP-3 showed no significant differences when comparing the areas of negative biopsies where tumors subsequently developed with those of the RP. However, we did observe a significant difference in the increased expression of MMP-2 (P=.002) and MMP-9 (P=.001) in the tumor area of the RP with respect to the corresponding area of the previous negative biopsy. CONCLUSIONS: Our data indicate a higher overall expression of MMP-2 and MMP-9 in the tumor area of the RP compared to the corresponding areas of the negative previous biopsy, which seems to be associated to the process of malignant transformation.

[What primary care physicians should know about new markers in prostate cancer]. / Qué debe saber el médico de primaria sobre los nuevos marcadores en el cáncer de próstata.

The use of prostate-specific antigen as a diagnostic tool in the screening of prostate cancer is reflected in an increase in the incidence, an increase in diagnosis at initial stages, and an increase in radical therapies, even at the expense of over-treatment in some cases. It is known from the data collected in the literature that not every patient with high prostate-specific antigen needs a biopsy, and that not every patient diagnosed with prostate cancer needs treatment. With the new emerging prostate markers, we will try to improve the specificity of prostate-specific antigen in the grey area (4-10 ng/ml) should be improved. This should avoid unnecessary biopsies. The sensitivity in the detection of significant prostate cancer with low prostate-specific antigen should also be improved in an attempt to reduce the risk of over-treatment. On the other hand, prognostic biomarkers with genomic tests will help to choose the best therapeutic option for the patient.

Results of adrenalectomy in lung cancer metastases. / Resultados de la adrenalectomía en la metástasis del cáncer de pulmón.

BACKGROUND: The aim of this study was to report our centre's experience over the past 15 years with patients with lung carcinoma and adrenal metastases treated sequentially with lung resection and adrenalectomy. PATIENTS AND METHODS: We analysed a retrospective series of 19 patients who underwent adrenalectomy for lung carcinoma metastasis. All patients were operated on at the same centre, between October 2000 and October 2015. We performed a descriptive analysis and an overall survival and disease-free survival analysis. RESULTS: The study included 13 men and 6 women. The most common primary lung tumour was adenocarcinoma, 87.5% of which were G3. In 7 patients, the adrenal metastasis was detected synchronously, and in 12 patients it was detected metachronously. The median size of the metastasis was 63mm. Twenty-one percent of the cases presented local recurrence, and 79% presented distant metastasis. The median DFS was 21.5 months, while the DFS at 5 years was calculated at 58.33%. The median overall survival was 37.3 months, while survival at 5 years was calculated at 42.86%. None of the prognostic factors evaluated were statistically significant. CONCLUSIONS: Adrenalectomy in cases of isolated lung carcinoma metastasis can offer increased overall survival. Age and the degree of differentiation of the primary lung carcinoma are the factors that most influence poorer survival.

[Current aspects of prostate cancer screening]. / Aspectos actuales sobre el cribado en el cáncer de próstata.

Screening programs for prostate cancer based on the determination of serum prostate specific antigen has led to overdiagnosis, and consequently overtreatment. A percentage of men diagnosed with prostate cancer have a tumour that will not progress, or do so slowly (overdiagnosis or pseudo-disease). This overdiagnosis rate ranges from 17-50%. Mass screening is defined as the systematic examination of asymptomatic men. Early detection or opportunistic screening involves the pursuit of individual cases being initiated by the doctor or the patient. In the case of a patient who requests a prostate specific antigen from their general practitioner, a number of issues on overdiagnosis, over-treatment and possible damage from the biopsy, should be explained to him. With data from randomised studies on prostate specific antigen and prostate cancer screening, population screening is not recommended by any urological society.

[Therapeutic effect of mitomycin C in the immediate postoperative period in patients with intermediate-risk non-muscle-invasive bladder tumors]. / Efecto terapéutico de mitomicina C en el postoperatorio inmediato de pacientes con tumores vesicales no músculo invasores de riesgo intermedio.

INTRODUCTION: Approximately 70-85% of transitional bladder cell carcinomas are non-muscle-invasive. After an initial surgery, around 60-90% will have a recurrence, being the highest risk period the first two years. Urothelium instability could be the main reason for recurrence in mid grade tumours, reason why a single dose of a chemotherapy after transurethral resection of the bladder (TURB) might be insufficient. That is why a deferred therapy in occasions associated with maintenance is recommended. PATIENTS AND METHODS: A prospective, controlled and randomized study was performed. We included non-muscle-invasive mid risk bladder tumours. All patients had initially a TURB performed and were randomized to receive a single dose of mitomycin C (MMC), in the immediate postoperative period. RESULTS: A total of 105 patients were included. Mean follow-up was 22, 70 +/- 8, 15 months. MMC was administered to 53 patients. Of these 66, 0% had no recurrence and 34.0% had a non-muscle-invasive recurrence. Of the 52 patients in the non MMC group, 53.8% had no recurrence and 44.2% had a non-muscle-invasive recurrence and only 1 patient had a muscle-invasive progression. We did not find significantly differences in time to recurrence in mid risk tumours when using immediate postoperative single dose of MMC or deferred therapy. There was only one case of myelosuppression. DISCUSSION: In mid risk non-muscle-invasive tumors, some studies suggest that early intravesical instillation of chemotherapy reduces the risk of recurrence after TURB. We could not show significantly differences when comparing postoperatorive MMC versus traditional deferred instillations.

Significance of collagenase 3 (matrix metalloproteinase 13) in invasive bladder cancer: correlation with pathological parameters.

PURPOSE: To determine if collagenase 3 expression is associated with stage progression and prognosis of bladder cancer. PATIENTS AND METHODS: Immunohistochemical staining for collagenase 3 was carried out on serial sections from specimens of 42 patients (32 males and 10 females) who underwent radical cystectomy for bladder cancer (median follow-up, 67.2 +/- 5.99 months). RESULTS: Immunohistochemical expression of collagenase 3 was detected in 13 (31%) patients. Pathological stage was pT2 in 12 (28.57%) patients, pT3a in 7 (16.6%), pT3b in 21 (50%) and pT4 in 2 (4.76%). Four tumours (9.52%) were grade II and 38 (90.47%) were grade III. Stage and tumours >3 cm in size were associated with bladder cancer progression-free survival and overall survival. We did not find any statistical differences with collagenase 3 expression related with stage and size. CONCLUSIONS: Immunohistochemical expression of matrix metalloproteinase 13 in invasive bladder cancer is not useful as marker for transformation and invasion. These findings should be evaluated in large multicentre prospective trials.

[Trombosis of the dorsal penis vein (of Mondor's phlebitis). Presentation of a new case]. / Trombosis de la vena dorsal del pene (Flebitis de Mondor). Aportación de un nuevo caso.

OBJECTIVE: We present a new case of trombosis of the superficial dorsal penis vein called Penile Mondor's disease. The characteristics of the disease are reviewed and the most usual diagnostic and therapeutic methods. METHODS: The case of a 41 year old man is reviewed who consulted for pain and induration on the proximal part of the penis. RESULTS: After phisical examination and Eco-doppler was made the diagnosis of Mondor's disease. He receibed treatment with non steroidal antiinflamatories and antibiotics. CONCLUSIONS: The dorsal vein thrombosis is a rare disease with pain an induration of the dorsal part of the penis. The ethiology can be traumatic, neoplasic, excesive sexual activity or abstinence. Is necesary the diferencial diagnosis with esclerosant linphangitis and the most important imaging is the Eco-doppler. The treatment is based in non steroidal antiinflamatories and antibiotics wit infection. The local aplication of heparine can be useful and the surgery with thrombectomy and resection is for persistent cases.

[Changes in the clinical and anatomo-pathological presentation of prostate cancer in Oviedo in the last 10 years (part I)]. / Cambio en el patrón de presentación del cáncer de próstata en Oviedo en los últimos 10 años: patrón de presentación, manifestaciones clínicas y anatomo-patológicas (parte I).

OBJECTIVES: To describe the clinical and pathological factors of prostate adenocarcinomas diagnosed in our department in the years 1995 and 2004. MATERIAL AND METHOD: We review the 216 patients diagnosed in both years, recording several features. RESULTS: The mean age was significatively lower in the year 2004. In that year, the increments of the PSA levels was the main reason for the diagnosis of the prostate cancer, followed by low urinary tract symptons (LUTS), while the LUTS was the main reason in 1995. There was a greater proportion of high grade tumors in 1995 and also in this year, high risk tumors were the most frequently found, while in 2004 low risk and low grade tumors were predominant. CONCLUSIONS: Due to the general determinations of PSA levels in asymptomatic patients in 2004, we found a greater proportion of high grade tumors in 1995 and lower grade tumors in 2004.

[Changes in the presentation pattern of the prostate cancer in Oviedo in the last 10 years: diagnostic and treatment (part II)]. / Cambio en el patrón de presentación del cáncer de próstata en Oviedo en los últimos 10 aõs: diagnóstico y tratamiento (parte II).

OBJECTIVES: To describe and compare the diagnostic and treatment factors of prostate adenocarcinomas diagnosed in our department in the years 1995 and 2004. MATERIAL AND METHOD: We review the 216 patients diagnosed in both years, recording several features. RESULTS: Significant differences were found in the mean of cylinders taken in the biopsies, being higher in 2004 than in 1995. Hormonal deprivation was the predominant treatment in 1995 followed by radical prostatectomy, while in 2004 radiotherapy (external beam or braquitherapy) was the most frequent therapy used followed by hormonal deprivation and radical prostatectomy. Independent factors to apply the treatment was the age (OR=5,6) and the risk groups (OR=2,8) in the year 2004 and only the age (>70 years vs < or =70) in the year 1995. CONCLUSIONS: The evolution held in treatment therapies for prostate adenocarcinomas, made this disease in terms of treatment a multidisciplinary disease obtaining better results.

[Pronostic factors in recurrence and progression of superficial bladder cancer. Risk groups (part I)]. / Factores pronósticos en la recidiva y progresión del cáncer superficial vesical. Grupos de riesgo (parte I).

INTRODUCTION: We have carried out a retrospective study on a series of superficial bladder tumours, analyzing the clinical-pathological factors that can determine the subsequent evolution of the tumour as for recurrence and progression. MATERIAL AND METHODS: They were revised on the whole 473, of which finally 419 superficial bladder tumours were useful for the study (223 primary tumours and 196 recurrent). Studies are carried out univariate and multivariate on 24 variables of each tumour referred to the characteristics and to the evolution of the tumour. RESULTS: We find significant differences in the free time to recurrence, diminishing it in the tumours that recurred in less than 12 months, in multiple tumours (3 or more tumours) and in bladder dome tumours. Also statistically significant differences existed when were studied two homogeneous groups of surgeons, while the treatment with bladder instillations increased it. The time to progression, diminishes in: Tumours that had recurred prematurely (in 6 months), tumours over 3 cm, high grade tumours and when two groups of surgeons were studied, we also find that the maintenance therapy with BCG (bacillus Calmette-Guerin) showed a greater time to progression versus induction therapy. DISCUSSION: The independent factors to explain smaller free time till superficial recurrence were: recurrence in the 1 degree year, multiplicity, surgical technique, not employment of bladder washes, treatment with low dose of BCG and use of intravesical therapy with induction therapy versus maintenance. About the progression, we objectify that the factors with greater influence in the progression were, recurrence in the first 6 months, grade (grade 2 and grade 3 + Tis) and treatment with maintenance therapy versus induction.

[Pronostic factors on recurrence and progression of superficial bladder cancer. Risk groups (part II)]. / Factores pronósticos en la recidiva y progresión del cáncer superficial vesical. Grupos de riesgo (parte II).

INTRODUCTION: We try to establish risk groups combining the characteristics of each bladder tumour, for a better monitoring of these patients. MATERIAL AND METHODS: Once known the variables implied in recurrence and progression we analyze the data to establish the extreme groups, so, the one with the worse and the one with the better prognostic, remaining a residual group that would correspond of the tumours of intermediate prognostic. RESULTS: From the results obtained, we can establish three risk groups: Bad prognostic group (high risk) : High grade tumours (G3), isolated or associated Tis and multiple or recurrent grade 2 tumours that were recurred in less than 6 months; Intermediate prognostic group: multiple TaG1 tumours, as well as not multiple Ta-1G2 and T1GI (less than 3 tumours) and Group of low risk: Single TaG1 tumours. DISCUSSION: According to these results the group of badly risk, involves a high risk of recurrence and progression. The most effective treatment was the BCG (bacillus Calmette-Guerin) with maintenance, requiring a long-term control, more intense in the 2 first years after the RTU. In the group of intermediate risk, the rates of long-term superficial recurrence were as high as those of the high risk group, being needed a long-term control, in this group was effective the treatment with chemotherapy or BCG being preferably the maintenance. Finally in the group of good risk we don't objectify progressions being the time to the recurrence the longest one, with stabilization of the rate of recurrences after one year.

[Treatment of erectile dysfunction with penile prothesis. Our experience]. / Tratamiento de la disfunción eréctil mediante el implante de prótesis de pene. Análisis de nuestra serie.

INTRODUCTION AND OBJECTIVES: The aim of this study was to review the current situation of penile prosthesis in the treatment of erectile dysfunction and to analyze the indications, degree of acceptability and complications in our experience. MATERIAL AND METHODS: From 1984 to 2003, 48 implants were inserted in men suffering from impotence due to different etiologies. The mean age was 55 years. Vascular disease, Diabetes and pelvic surgery were the most common pathologies recorded. The type of prothesis inserted were malleable inactive in 7 cases (14.58%), Jonas6, Acu-form1. Inflable active with 3 components in 19 cases (39.58%), AMS 700 plus17, Alpha2. Inflable active integrated in 5 cases (10.41%) Hydroflex4, Dynaflex1. Inflable active with 2 components in 17 cases (35.4%), Ambicor2, Mark II15. RESULTS: Infection of the prosthesis was observed in 6.25% of the cases. This infectious complication required removal of the prosthesis. 4.16% of the cases complained of mechanical failure that required change of the prosthesis. 80% of the patients were satisfied with the results. CONCLUSIONS: Penile prostheses continue to be an effective and valid therapeutic alternative in impotent. Although the complication rate is low, adequate information must be provided to the patient.

[Determination of NMP-22 as recurrence marker in bladder cancer. Preliminary study]. / Determinación de NMP-22 como marcador de recidivas en el cáncer vesical. Estudio preliminar.

OBJECTIVES: The present study was conducted to determine the efficacy of NMP-22 as a diagnostic test for recurrence of bladder tumors and to compare its efficacy with urine cytology. METHODS: 30 patients (25 male, 5 female), aged 41-87 years (mean 73.4), with bladder tumor were evaluated by cytology, cystoscopy and determination of NMP-22 at 3 and 6 months post-TUR of the bladder. A positive test was defined as NMP-22 greater than 10 U/ml. RESULTS: 80.7% were T1, 15.3% T2-T3, 76.8% were grade I and II, and 23.2% were grade III. NMP-22 showed a sensitivity of 69%, a specificity of 64%, a positive predictive value of 52% and a negative predictive value of 78%, using tumor recurrence at 3 and 6 months as the unit of analysis, for a recurrence rate of 36%. Cytology showed a sensitivity of 44%, a specificity of 92%, a positive predictive value of 77% and a negative predictive value of 74%. When both tests were used, we obtained a sensitivity of 87.5%, a specificity of 64.2%, a positive predictive value of 58.3% and a negative predictive value of 90%. In grade I tumors, determination of NMP-22 had a sensitivity of 100%, a specificity of 77.7%, a positive predictive value of 60% and a negative predictive value of 69%. CONCLUSIONS: NMP-22 showed an acceptable sensitivity but a low positive predictive value, therefore control cystoscopic evaluation cannot be avoided. The sensitivity and negative predictive values increased when NMP-22 and cytology are used in combination. We found NMP-22 to be a very useful marker for recurrence of low grade tumors.

[Quantification of bladder tumor antigen (BTA trak) and its correlation with bladder cancer grade and stage]. / Cuantificación del antígeno tumoral vesical (BTA trak) y su correlación con el grado y estadio del cáncer vesical.

OBJECTIVE: To analyze the efficacy of the BTA Trak test as a diagnostic marker for bladder cancer, determine its correlation with tumor grade and stage, compare its sensitivity with urinary cytology and its utility in urological conditions other than bladder cancer. METHODS: 77 patients comprised the study; 33 with bladder cancer and 44 without. A urine sample was obtained from all patients for the BTA Trak test and another three samples for urinary cytology from each of the 33 patients with bladder cancer. Of the 44 patients without bladder cancer, 36 had conditions involving the urinary tract and 8 presented conditions without urothelial involvement. The BTA Trak test was repeated three months after treatment in 11 of the patients with bladder cancer and three months after the first test in 13 patients without bladder cancer. RESULTS: Using BTA Trak threshold values of 14 U/ml as first reference and 50 U/ml as the value indicating clinical warning, these were found to be higher in 24 of 33 patients with bladder tumor (sensitivity 72.7%). By tumor stage, BTA Trak was positive in 12 of 21 pT1 (sensitivity 57%) and in 11 of 11 pT2 (sensitivity 100%). Concerning tumor grade, values were higher than threshold in 13 of 22 GI-II (sensitivity 59.9%) and 10 of 10 GIII (sensitivity 100%). Urinary cytology was positive in only 8 cases (sensitivity 24.4%). In the patients without bladder cancer, values are higher than threshold in 3 of 8 patients with urological conditions without urinary tract involvement and 14 of 36 with a probable urothelial involvement without tumor, accounting for an overall sensitivity of BTA Trak of 61.4%. The BTA Trak test three months after treatment showed lower value in 7 of 8 patients with bladder tumor and pretreatment values higher than threshold. CONCLUSIONS: The BTA Trak test is a simple quantitative method with a high sensitivity for the diagnosis of bladder tumors, especially those in the advanced stages and grades. It is superior to cytology, although it has a lower specificity, particularly in conditions with urinary tract involvement.

[Significance of random biopsies of healthy mucosa in superficial bladder tumor]. / Significado de las biopsias al azar de mucosa sana en el tumor de vejiga superficial.

OBJECTIVE: To analyze the characteristics of the random biopsies of normal-appearing mucosa taken during TUR of superficial bladder tumors and to correlate them with the outcome and characteristics of the superficial tumor. METHODS: Multiple random biopsy specimens from normal-appearing areas of 300 TUR procedures for primary or recurrent superficial urothelial carcinoma were analyzed. Preoperative cytologies were obtained in most of the patients and tumor number, localization, size, stage and grade according to the WHO classification were determined. In patients with multiple tumors, the stage, size and grade of the worst tumor were utilized. Patients who showed a risk of recurrence during follow-up received intravesical therapy postTUR of the bladder. The site and characteristics of recurrence were analyzed and compared with the random biopsy findings. RESULTS: In 38 superficial tumors (12.7%), significant histological changes were found in the random biopsies of normal-appearing mucosa taken during resection. A significant difference was found between patients with and without positive random biopsies only for tumor stage. Statistically significant differences were found when comparing the primary and recurrent tumors, due to the greater number of high and moderate grade tumors in the primaries. There were significant differences in regard to the positive preoperative cytologies between the patients with negative and those with positive random biopsies. No statistical correlation was found between the localization of the superficial tumor and a positive biopsy or between the latter and the site of tumor recurrence. There were 126 recurrences (42%); mean time to recurrence was 13.5 months (median 9.5 months). No significant difference was found (log-rank) for time to recurrence in patients with positive or negative random biopsies, but significant differences were found when we analyzed the number of superficial tumors and the use of intravesical therapy, but not for the type of therapy. CONCLUSIONS: Multiple random biopsies permit a better categorization of the tumor and complete staging. The outcome and the decision to administer intravesical therapy following TUR of the bladder are influenced by the foregoing. The practical results of random biopsies, however, are scanty, since the prognostic significance of the histological changes found in these biopsies is not worse than that of the superficial tumor resected. There are, however, a few cases with a higher risk of recurrence and/or progression than the superficial tumor. Preoperative cytology is useful in the selection of these patients. Furthermore, since the proportion of high grade tumors is higher in primary tumors, performing multiple biopsies is mandatory in these cases if previous urine cytology is not available.

[Innervation of the human adrenal gland]. / Inervación de la glándula suprarrenal humana.

OBJECTIVE: To study the innervation of the human adrenal gland by immunohistochemical techniques using monoclonal antibodies against the 200-kDa phosphorylated neurofilament and S-100 protein, specific markers of the axons and Schwann cells, respectively. METHODS: 24 specimens of normal adrenal gland from patients that had undergone radical nephrectomy for a renal tumor were analyzed. The tissue was embedded in paraffin and prepared for analysis by immunohistochemical techniques with the indirect peroxidase method using primary monoclonal antibodies against the 200-kDA phosphorylated neurofilament and protein S-100. RESULTS: The nerves localized in the adrenal gland form a subcapsular plexus where branches arise that extend to the medulla and come into contact with the enterochromaffin cells and medullary neurons. The adrenal neurons are restricted to the medulla; they are dispersed or form ganglia. The satellite cells of the medullary ganglia and the sustentacular cells were positive for S-100. CONCLUSIONS: Most of the nerve fibers penetrate into the human adrenal gland, extending directly to the medulla apparently without coming into contact with the cells of the adrenal cortex and form similar connections to the synaptics with the chromaffin cells and the medullary neurons. The microganglia of the human adrenal gland are dispersed and comprised of few neurons.

[Tumor bladder antigen (TBA). A new method for the diagnosis and detection of recurrence of bladder cancer]. / Antígeno vesical tumoral (BTA). Nuevo método para el diagnóstico y detección de recidiva del cáncer vesical.

OBJECTIVE: To compare the usefulness and accuracy of the BTA test versus urinary cytology. METHODS: The BTA test was performed in 45 patients distributed into three groups: group I comprised patients with hematuria of unknown origin; group II had a diagnosis of bladder cancer; and group III comprised patients who had undergone TUR for a bladder tumor and were undergoing endoscopic control evaluation. The sensitivity and specificity of each diagnostic method were determined for each group of patients. RESULTS: The BTA test showed a higher sensitivity than urinary cytology in all groups, the difference being significant for groups II and III. Its specificity, however, was lower than that of cytology in groups I and III, and similar in group II. CONCLUSION: The BTA test is a simple and useful method for the diagnosis and follow-up of bladder cancer. It has a higher sensitivity than urinary cytology, although its specificity is lower due to the higher number of false positives observed in patients with inflammatory bladder conditions. Randomized studies are warranted to determine if the accuracy of urinary cytology can be enhanced with the combined use of the BTA test which has been demonstrated to have a higher specificity.