Elevation of serum tumor markers caused by hydronephrosis due to upper tract urothelial carcinoma

Abstract

The aim of this study was to explore the association of changes in classic serum tumor markers and pathological and clinical manifestations of upper tract urothelial carcinoma (UTUC) and to analyze its possible mechanism. A retrospective, descriptive analysis was performed in consecutive patients who were diagnosed UTUC during 2014 – 2018 year in our hospital. Detection of classic serum tumor markers (CSTMs, including CA199 、 CA242 、 CA724 、 CA125 、 CEA 、 AFP and SCC-Ag) and pathological manifestations of tumor was collected. The status of hydronephrosis caused by tumor, tumor load and the expressions of CA199, CA724 and CEA in UTUC was also analyzed. Higher rate of abnormal changes in CSTM was found in UTUC patients and it could be dropped off after surgical treatment. There was a correlation between UTUC and the classic serum tumor markers including CA199 、 CA242 、 CA724 and CEA. Tumor metastasis and hydronephrosis induced by tumor may be two independent reasons which caused this phenomenon. Immunohistochemistry technology proved CA199, CA724 and CEA were almost expressed in almost all UTUC tissues. We suggested a hypothesis that the pressure acting on tumor caused by hydronephrosis may extrude tumor markers produced from UTUC into blood and even promote metastasis. This may be helpful for distinguished the upper urinary tract tumor without definite diagnosis.