Serum Levels of CA15-3, AFP, CA19-9 and CEA Tumor Markers in Cancer Care and Treatment of Patients with Impaired Renal Function on Hemodialysis

Abstract

Since renal failure causes decrease in tumor marker excretion, use of these markers in cancer care and treatment in patients with renal insufficiency or hemodialysis is controversial. The aim of this study was to investigate differences of serum levels of tumor markers CA15-3, AFP, CA19-9 and CEA in patients with impaired renal function. A total of 100 patients referred to the Tabriz Immam Reza and Amiralmomenin hospital from June 2010 to November 2011 were selected for study. Subjects were divided to 3 groups of healthy, dialysis and renal failure but non hemodialysis cases, the last category being re-grouped based on creatinine clearance. No significant relationship between different groups in serum levels of CEA (P=0.99) and CA19-9 (P=0.29) tumor markers was found. A significant correlation was observed between serum levels of AFP (P<0.001) and CA15-3 (P<0.001) and also a tendency between creatinine clearance and CEA (r=0.05, P=0.625). Creatinine clearance significantly correlated with AFP (P<0.001, r=0.53) and CA15-3 (p=0.00, r=-0.412), but not CA19-9 (P=0.089, r=-0.171). According to results of this study it appears that use of tumor markers in patients with impaired renal function should be performed with special precautions.

Characteristics and Prognosis of Hepatocellular Carcinoma in Japanese Patients Undergoing Dialysis

“…In addition, patients undergoing dialysis may be less likely to undergo tumor marker measurements even if they are at risk of HCC, possibly due to lower awareness on the importance of measuring tumor markers during HCC surveillance . Although in this study there was no difference in serum AFP levels between the dialysis and non‐dialysis groups, possibly due to the influence of renal function on AFP , we found that serum DCP levels, which are reportedly not influenced by renal function , were significantly higher at HCC diagnosis in patients undergoing dialysis than in the non‐dialysis controls. Furthermore, it may be difficult at dialysis clinic to assess the risk of developing HCC accurately, based on the degree of liver fibrosis or hemosiderosis, age, or status of hepatitis viruses including viral genotype or viral loads.…”

Value of urinary microalbumin test in cancer patients with borderline serum creatinine level

“…A recent study has shown the use of tumor biomarkers in cancer patients with impaired renal function should be done with precaution. 15 This highlights the importance of detecting early kidney damage by testing urinary MA in cancer patients for interpreting the results of tumor biomarkers.…”

Serum tumor markers in chronic kidney disease: as clinical tool in diagnosis, treatment and prognosis of cancers

“…Finally, routine screening of the transplant population with serum tumor markers was not useful because of the low sensitivity and specificity of these tests. In addition, studies by Estakhri et al 2 and Tzitzikos et al 22 showed that CA 19-9 with presence of increased levels is not specific for neoplasms after hemodialysis treatment. Wood et al 28 concluded that single isolated determinations of CA 125 and CA 19-9 are not reliable indicators of malignancy in renal transplant patients.…”

“…Tumor marker concentrations in healthy individuals is low or zero, and its increasing concentrations suggest the incidence of related tumor (Figure 1). 2 Tumor markers are widely used in monitoring cancer patients and for screening of certain tumors. It has recently been shown that concentrations of some tumor markers are higher in patients with chronic kidney disease (CKD) than in healthy subjects ( Table 1).…”