Clinical Usefulness of CEA, CA19-9, and CYFRA 21-1 as Tumor Markers for Urothelial Bladder Carcinoma

Abstract

Objective: To evaluate the usefulness of measuring serum CEA, CA19-9, and CYFRA 21-1 levels for the diagnosis and monitoring of bladder cancer. Materials and Methods: Serum levels of CEA, CA19-9, and CYFRA 21-1 were measured in 85 patients with bladder cancer. The absolute level of each marker and the positive rate were compared with the clinical stage and histological grade of the tumor. Changes of the markers were assessed in patients with or without disease progression, and the correlations between survival and positivity/negativity of these markers were also evaluated. Results: A higher serum level of CYFRA 21-1 was significantly correlated with higher tumor stage (p < 0.01) and higher grade (p < 0.05). In contrast, serum CEA and CA19-9 levels did not differ significantly among each stage and grade. The CYFRA 21-1 level increased significantly along with disease progression (from 7.33 ± 13.3 to 55.9 ± 127 ng/ml, p < 0.01). Patients who were positive for CYFRA 21-1 had significantly worse disease-specific survival (p < 0.0001, log rank test). Conclusion: Serum CYFRA 21-1 seems to be a marker of advanced- and high-grade urothelial carcinoma of the bladder. It is useful for monitoring this disease and for predicting the prognosis. In contrast, the clinical usefulness of CEA and CA19-9 as tumor markers was not demonstrated.

Significance of CA19-9 in Predicting the Prognosis of Urothelial Carcinoma: A Hospital Based Study from Nepal

“…The percentage of rise in CA 19-9 level in patients with metastatic disease (75.0%) was significantly higher than in patients without metastasis (18.1%) (p value 0.001*) (Hegele et al, 2010). CA 19-9 level was also found to be increased in high-grade tumors (66.6%) as compared with low-grade tumors (22.2%) (p value 0.001*) (Washino et al, 2011). Therefore, even though no serological tumor marker has so far been amply sensitive and specific to be used in screening for transitional cell carcinoma, elevated pre-operative levels of carbohydrate antigen (CA) 19-9 correlate with advances stages of disease and a poorer clinical outcome.…”

940 Loss of Keratin 19 Predisposes to the Development of Cholestatic Liver Disease

“…For example, recent study showed that loss of canal of Hering marked with K19 staining appeared in the early stage of primary biliary cirrhosis (PBC), and this finding may provide support to clinical diagnosis of PBC [51]. Further, K19 is also often expressed in a variety of human cancers, such as urothelial bladder carcinoma, advanced thyroid cancer and hepatocellular carcinoma (HCC) [10,[44][45]52]. Specifically, in the subtype of HCC which characterized with expression of K19, it is histologically poorly differentiated and exhibit aggressive tumour activity.…”

“…the lining of gastroenteropancreatic and hepatobiliary tracts) are among tissues with the highest K19 expression (Table 2) [10,[44][45]. Of note, K19 expression is restricted to the biliary system in adult liver under physiological condition, and therefore, K19 represents as an established marker for cholangiocytes [46].…”

“…The cultured K19-positive HCC cells still exhibited high invasive potential in vitro [53][54]. Because of that, K19 serves as an important serum tumor marker as well as a pathological adjunct in diagnostics of carcinoma of unknown primary [13, [44][45].…”

CYFRA21-1 levels could be a biomarker for bladder cancer: a meta-analysis

“…According to the inclusion criteria, 3 studies (Sánchez-Carbayo et al, 1999;Andreadis et al, 2005;Washino et al, 2011) met the inclusion criteria and were included in the metaanalysis. The flow chart of study selection is shown in Figure 1.…”