Role of serum CA 19-9 as a tumor marker in TCC bladder

Abstract

Background: There is a dearth of reliable blood and urine markers for transitional cell carcinoma of urinary bladder. CA 19-9 is a well-known marker for gastrointestinal malignancies and is being investigated for other malignancies including carcinoma bladder. In this prospective study, we evaluated the role of serum CA 19-9 as a tumor marker and correlated its level with tumor grade and stage.Methods: One hundred and fifteen patients with transitional cell carcinoma of urinary bladder and 69 healthy volunteers, as controls were included in the study. Preoperative blood sample was analysed for level of CA 19-9 using ELISA kit (normal - 0 U/ml to 37U/ml) and were correlated with grade and TNM stage of tumor.Results: The range of the control group is 2-38U/ml (mean: 17.67±9.68U/ml); TCC group is 1-94U/ml (mean: 37.12±31.52U/ml) (p=0.304). When CA 19-9 level >37IU/ml was taken as cut-off for a positive test, sensitivity of detecting T3 disease, T4 disease, MIBC, presence of node and high grade tumour were 80%, 75%, 70.3%, 78% and 57.8% respectively. However, there was a statistically significant increase in levels of CA19-9 in relation to higher grade (<0.001), presence of muscle invasion (<0.001), T stage (<0.001) and N stage (<0.001).Conclusions: Serum CA19-9 is almost invariably raised in patients with high grade and invasive disease. Thus, it has a place as a prognostic marker rather than as a diagnostic tool due to its low sensitivity for TCC bladder.