Mesane kanseri tanısında serum Ca 19-9 ve Ca 125 düzeylerinin rolü

The role of the serum levels of CA 19-9 and CA 125 in the diagnosis of bladder cancer

Background and design: A non-invasive marker test for bladder carcinoma would not only decrease the cost, but also improve patient quality of life. For bladder carcinoma, tumor growth or invasion associated mo¬lecules may serve as. markers and they may be detected non-invasively. Carbonhydrate antigen (CA) 19-9 and 125 are useful tumor markers for huroan cancer, especially in gastrointestinal and gynecologic malignencies. In this study, our aim is to determine the efficiancy of serum CA 19-9 and 125 levels for the detection of bladder carcinoma different from other studies. For this purpose, serum samples were obtained from 49 patients with bladder carcinoma and from 24 patients with benign prostate hyperplasia and 23 patients with nephrolithiasis. Approximately 2 ml serum sample was obtained and aliquated for electro-chemiluminesence immunoassay. Results: CA 19-9 was determined as positive for 6 patients in bladder carcinoma group. It was positive for 1 patient in the benign prostate hyperplasia and for 4 patients in the nephrolithiasis group (p > 0.05). CA 125 was determined as positive for only one patient in the bladder carcinoma group. 4 patients in the nephrolithiasis group had positive CA 125 level (p > 0.05). The overall sensitivity and specifity were % 12.2 and % 89.4 for CA 19-9. CA 125 has % 2 sensitivity and %91.5 specificity for bladder carcinoma. Conclusion: In the population tested, serum CA 19-9 and CA 125 determined as not effective in the diagnosis of bladder carcinoma with regard to the sensitivity and specifity values and they could not offer more sensitivity than the other tumor markers and/or cytology for bladder carcinoma.

___

  • 1. Landis SH, Murray T, Bolden S. and Wingo PA. Cancer Statistics, 1998. CA Cancer J Clin, 1998; 48: 6-9.
  • 2. Heney NM, Natural history of bladder cancer. Urol Clin North Am, 1992; 19: 429-432.
  • 3. Soloway MS, The management of superficial bladder cancer. Cancer, 1980; 45: 1856-1858.
  • 4. Murphy WM, Diseases of the urinary bladder, urethra, ureters and renal pelvis. In: Urological Pathology. Edited by W.M. Murphy. Philadelphia: W.B. Saunders Co, pp, 1989; 34-146.
  • 5. American Joint Committee on Cancer, Staging of cancer at genito-urinary sites. In: Manual for staging Cancer, Ed. 3. Philadelphia: J.B. Lippincott Co, pp, 1988; 194-5.
  • 6. Soloway MS. Invasive bladder cancer: selection of primary treatment, Semin Oncol, 1990; 17: 551-554.
  • 7. Heney NM, Ahmed S, Flanigan MJ, Frable W, Corder MP, Haferman MD. and Hawkins IR. Superficial bladder cancer progression and recurrance. J Urol, 1983; 130: 1083.
  • 8. Friedell GH, Soloway MS, Hilgar AG. and Farrow GM. Summary of workshop on carcinoma in situ of the bladder. J Urol, 1986; 136: 1047.
  • 9. Weiner HG, Vooijis GP. and Van’t Hof-Grootenboer B. Accuracy of urine cytology in the diagnosis of primary and recurrent bladder cancer. Acta Cytol, 1993; 37: 163.
  • 10. Kıkuno N, Urakami S, Shigeno K, Shiina H, Igawa M. Urachal carcinoma associated with increased carbonhydrate antigen 19-9 and carcinoembryonic antigen. J Urol, 2001; 166: 604.
  • 11. Izes JK, Dyer MW, Callum MG, Bankes P, Libertino JA, McCaffrey JA. CA 125 as a marker of tumor activity in advanced urothelial malignancy. J Urol, 2001; 165: 1908.
  • 12. Epstein JI, Amin MB, Reuter VR, Mostofi FK. The World Health Organization / International Society of Urological Pathology consensus classification of urothelial (transitional cell) neoplasms of the uriner bladder. Bladder Consensus Conference Comitee. Am. J. Surg Pathol, 1998; 22 : 1435-1448.
  • 13. Sobin LH, Wittekind C. International Union Against Cancer (UICC). Urinary bladder. In TNM: Classification of Malignant Tumors. New York, Wiley- Liss, 1997; 187-190.
  • 14. Murphy WM. Current status of urinary cytology in the evaluation of bladder neoplasms. Hum Pathol, 1990; 21: 886.
  • 15. Droller MJ, Current concepts of tumor markers in bladder cancer. Urol Clin North Am, 2002; 29: 229.
  • 16. Lokeshwar VB, Soloway MS. Current bladder tumor tests: Does their projected utility fulfill clinical necessity. J Urol, 2001; 165: 1067.
  • 17. Ohnita T, Sakai H, Matsuo M, Hisamatsu H, Shimokawa I, Saito Y. Primary signet ring cell adenocarcinoma of the bladder with elevated serum carbohydrate antigens 19-9 and 50. J Urol, 1998; 159: 1641.
  • 18. Abel PD, Cornell C, Buamah PK, Williams G. Assessment of serum CA 19.9 as a tumour marker in patients with carcinoma of the bladder and prostate. Br J Urol, 1987; 59: 427.
  • 19. Guarnaccia S, Pais V, Grous J, Spirito N. Adenocarcinoma of the urachus associated with elevated levels of CA 125. J Urol, 1991; 145: 140.