CA19-9 as a Serum Marker for Poor Prognosis in Urothelial Carcinoma

Sashide, Kazuhiko; Isobe, Hideyuki; Wakumoto, Yoshiaki; Hanazawa, Kisaburo; Fujita, Kazuo; Fujime, Μakoto

doi:10.1159/000075963

Cited by 13 publications

(8 citation statements)

References 6 publications

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“…To date, a useful serum marker of UC has not been established, and considering the aggressive nature of plasmacytoid UC, a biomarker is urgently needed. High serum CA19‐9 in UC patients has been correlated with poor outcome . However, histological variation was not considered in these studies.…”

Section: Discussionmentioning

confidence: 97%

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Urinary bladder urothelial carcinoma with concurrent plasmacytoid and micropapillary differentiations: A report of two cases with an emphasis on serum carbohydrate antigen 19‐9

Makise

Morikawa

Takeshima

et al. 2015

Pathology International

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We report two cases of urinary bladder urothelial carcinoma (UC). In both, histological examination of a transurethral resection specimen of the bladder tumor revealed UC with plasmacytoid and micropapillary differentiations. In Case 1, residual plasmacytoid UC deeply invaded the extravesical fat tissue of the radical cystectomy specimen, and metastatic carcinoma was found in almost all the dissected lymph nodes. Despite adjuvant chemotherapy and radiotherapy, the patient died 25 months postdiagnosis. Elevated serum carbohydrate antigen 19-9 (CA19-9) returned to near normal levels after radical cystectomy, but they increased shortly before death. In Case 2, no residual carcinoma was found in the radical cystectomy specimen or lymph nodes. Postoperative serum CA19-9 was maintained at normal levels, and the patient remains alive without recurrence or metastasis. Although plasmacytoid and micropapillary UC are known aggressive variants of UC, plasmacytoid UC may be more aggressive. Serum CA19-9 could serve as a useful biomarker to monitor progression of plasmacytoid UC.

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Section: Discussionmentioning

confidence: 97%

“…High serum CA19-9 in UC patients has been correlated with poor outcome. 15,16 However, histological variation was not considered in these studies. We evaluated immunohistochemical CA19-9 expression in the TUR specimen and serum CA19-9 level because of a case report of plasmacytoid UC with elevated serum CA19-9.…”

Section: Discussionmentioning

confidence: 99%

Urinary bladder urothelial carcinoma with concurrent plasmacytoid and micropapillary differentiations: A report of two cases with an emphasis on serum carbohydrate antigen 19‐9

Makise

Morikawa

Takeshima

et al. 2015

Pathology International

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“…In recent years, cases of urothelial carcinoma displaying high serum level of CA 19-9 have been reported sporadically and investigators have begun studying the diagnostic significance of CA19-9 in the domain of urology as well. [1423] CA 19-9 is a cancer-related carbohydrate antigen and is recognized by using a monoclonal antibody against colorectal cancer. Structurally, it is a Sialyl-Lewis—with sialic acid combined with lea antigen, a blood group carbohydrate.…”

Section: Discussionmentioning

confidence: 99%

“…[89] CA19-9 is now a well-known marker for pancreatic carcinoma and has also been reported to be positive in gastrointestinal cancers, papillary carcinoma of thyroid, and endometrial adenocarcinomas. [10–14] In the recent years, cases of urothelial carcinoma displaying high serum CA19-9 level have been reported and investigators have begun studying the diagnostic significance of CA19-9 in the domain of urology as well. CA 19-9 has been studied alone as well as with other markers, but the results have not been consistent.…”

Section: Introductionmentioning

confidence: 99%

CA 19-9 as a serum marker in urothelial carcinoma

Pall¹,

Iqbal²,

Singh³

et al. 2012

Urol Ann

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Introduction:CA 19-9 is a carbohydrate antigen related to Lewis A blood group antigen. It is well-known marker for pancreatic carcinoma and is being investigated for other malignancies including carcinoma bladder. We evaluated the role of serum CA 19-9 as a tumor marker and correlated its level with tumor stage and grade.Materials and Methods:Seventy-five patients with histologically proven urothelial carcinoma were included in this study as case and 25 healthy volunteers as control. Preoperative 5 ml blood sample was collected. Serum level of CA 19-9 was measured using solid-phase enzyme-linked immunosorbent assay kit. The value of CA19-9 was expressed in U/ml and 37 U/ml was taken as cut-off upper value of normal.Results:The range of CA19-9 in patients of urothelial carcinoma was 2 to 122 U/ml with a mean of 26.33±29.28, while in control, it was 8.48±5.01 U/ml (P<0.001). The sensitivity of CA19-9 was 29%. Serum CA19-9 was significantly elevated in invasive disease in comparison with superficial disease (47.17±34.43 vs 16.53±20.13) (P<0.001). Significantly high proportion of patients with invasive disease had value ≥37 U/ml (14/24 [58.3%] vs 8/51 [15.7%]) with P value <0.001. High proportion of high-grade tumor had raised value, 14/34 (41.25%); all patients with metastatic disease had value more than 37 U/ml.Conclusions:Serum CA19-9 is a marker of aggressiveness of urothelial carcinoma and is almost invariably raised in patients with metastatic disease. Thus, it may be used as a prognostic marker but not as a screening tool due to its low sensitivity.

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“…The investigators evaluated the serum CA19-9 levels based on a cutoff level of 37 U/ml in 164 urothelial carcinomas [1] . The overall positive rate of serum CA19-9 levels was 17.1% including the urinary bladder (138 cases, positive rate 15.0%), upper urinary tract (25 cases, positive rate 28.0%), and urethral cancer (1 case, positive rate 0%).…”

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confidence: 99%