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Abstract

Carcinoembryonic antigen (CEA) and tissue polypeptide antigen (TPA) levels in serum and urine from 25 patients with bladder cancer and 42 patients with cancer of the renal pelvis/ureter have been evaluated as an aid for clinical diagnosis of urothelial cancer. The tumour CEA content varied markedly, from values obtained in normal urothelium up to 822 and 7306 ng/g wet tissue in cancer of the renal pelvis/ureter and bladder cancer, respectively. Serum and urine CEA levels were found not to correlate with the tumour CEA content. Serum CEA levels were found increased over 5 microg/L in up to 16% of bladder cancer patients, but only in 4.8% in renal pelvis/ureter cancer. Urine of cancer patients contained usually normal CEA levels. Increased serum TPA levels were found in 48% and 35.7% of patients with bladder cancer and cancer of renal pelvis/ureter, respectively. Urine TPA levels were significantly increased in both, patients with bladder cancer (p<0.001) and cancer of renal pelvis/ureter (p<0.01). The median values of urine TPA were 59, 1095 and 1325 U/L, in controls, patients with bladder cancer and cancer of renal pelvis/ureter, respectively. However, considering previously described increase of TPA in inflammatory diseases of urinary tract and in renal failure patients, results of urinary TPA obtained in the diagnostic workup of urothelial cancer should be cautiously interpreted. This study shows that serum and urine levels of CEA and TPA have no diagnostic accuracy required for clinical diagnosis of urothelial cancer.

A Systematic Review of the Diagnostic and Prognostic Value of Urinary Protein Biomarkers in Urothelial Bladder Cancer

“…The weighted mean values for sensitivity and specificity are 84.1% and 96.6%, respectively (based on 277 cases and 311 controls). However, Stefanovic et al reported that TPA lacks diagnostic accuracy [ 62 ], and Carbin et al reported that TPA is only effective if 24 hour urine samples are analysed [ 63 ]. Additionally, although the averaged sensitivity/specificity appear higher than the averaged sensitivity/specificity for other cytokeratin based tests (UBC and Cyfra 21-1), in a direct comparison of TPA and Cyfra 21-1 Sanchez-Carbayo found TPA to be slightly inferior to Cyfra 21-1, indicating that the equivocal studies have overestimated the performance of TPA [ 61, 62 ].…”