Table 1.
Advantages, Disadvantages, and Potential Uses of Currently Tested Bladder Cancer Markers
| Marker | Advantages | Disadvantages | Potential Uses |
|---|---|---|---|
| Cytology | High specificity, high sensitivity | Low sensitivity for low-grade TCC; | Screening for recurrence in patients |
| for high-grade TCC | subject to interpreter variability; 24 | with history of bladder cancer | |
| hours for results | |||
| BTA stat | Fast, inexpensive; can be done in | Low specificity with benign | May be useful in combination |
| office setting; high sensitivity for | genitourinary conditions; non- | with another marker | |
| all tumors grades/stages; high | urothelial malignancies; recent | ||
| specificity in the healthy | intravesicle therapy or bladder/ | ||
| prostate manipulation | |||
| BTA TRAK | High sensitivity for all tumor | Same as BTA stat | Predict likelihood of recurrence |
| grades/stages; good specificity | using serially measured levels | ||
| in the healthy; quantitative | |||
| NMP22 | High sensitivity for all tumor | Specificity lower than cytology | Predict tumor stage and likelihood of |
| grades/ stages; quantitative | recurrence; can utilize high negative | ||
| predictive value to individualize | |||
| surveillance schedule | |||
| Telomerase | High sensitivity for all tumor | Instability in urine has yielded | Potentially replaces cytology as first- |
| grades/stages; equal/ better | dramatically different results in | line surveillance for recurrence; can | |
| specificity than cytology | different studies; not widely available | be used for screening the high-risk | |
| or general population; can possibly | |||
| predict likelihood of recurrence | |||
| HA/HAase | High sensitivity and specificity for | Not widely available | Potentially replaces cytology as |
| all tumor grades and stages and in | first-line surveillance for recurrence; | ||
| the presence of other genitourinary | can be used for screening the | ||
| conditions; can distinguish between | high-risk or general population | ||
| high-low-grade tumors | |||
| FDP | Fast, inexpensive; can be done in | Lower specificity than cytology, | May be useful in combination |
| office setting; higher sensitivity | especially in the presence of benign | with another marker | |
| than cytology for low-grade tumors | genitourinary conditions | ||
| CK20 | High sensitivity for all tumor | Very few studies have been done; | Can potentially detect pre-malignant |
| grades and stages; high specificity | results not yet confirmed | disease; predict likelihood of | |
| in the healthy | recurrence |