TPA, TATI, CEA, AFP, β-HCG, PSA, SCC, and CA 19-9 for Monitoring Transitional Cell Carcinoma of the Bladder

Abstract

A total of 76 patients with transitional cell carcinoma of the bladder were prospectively monitored with simultaneous serum value estimations of tumor polypeptide antigen (TPA), tumor-associated trypsin inhibitor (TATI), carcinoembryonic antigen (CEA), alpha-fetoprotein (AFP), beta-human chorionic gonadotropin (beta-HCG), prostatic specific antigen (PSA), squamous cell carcinoma antigen (SCC), and CA 19-9 in different stages and phases of their disease. In locally advanced disease positive values were noted for TATI in 22/28 patients (78.5%), for TPA in 17/28 (60.7%), for CA 19-9 in 10/28 (35.7%), for CEA 11/28 (39.2%), for beta-HCG in 3/28 (10.7%), for PSA in 6/28 (21.4%), for SCC in 6/28 (21.4%), and for AFP in 0/28. In metastatic disease elevated levels were observed for TATI in 43/48 patients (89.5%), for TPA in 41/48 (85.4%), for CA 19-9 in 19/48 (39.5%), for CEA in 20/48 (41.6%), for beta-HCG in 6/48 (12.5%), for PSA in 7/48 (14.5%), for SCC in 8/48 (16.6%), and for AFP in 1/48 (2.1%). In metastatic disease TATI and TPA values were significantly modified in patients with complete remission and TATI, TPA, and CA 19-9 in patients with partial remission and nonresponders. In T2-T4-N0M0 tumors, TPA, TATI, CA 19-9, and CEA were significantly increased in nonresponders. In patients with complete remission, a change in serum TATI, TPA, and CA 19-9 levels cannot be evidenced with the available numbers. The concurrent determination of TATI and TPA in T2-T4N0M0 tumors and TATI, TPA, and CA 19-9 in generalized disease could predict the response to chemotherapy. This study indicates that only the determination of TATI and TPA and in some degree the CA 19-9 is a potential tool for monitoring the efficacy of treatment.

Differential expression of trypsinogen and tumor-associated trypsin inhibitor (TATI) in bladder cancer

“…Serum concentrations of TATI have previously been found to be potentially useful in monitoring the disease activity and response to treatment in advanced bladder cancer (27) and we have shown that serum TATI is an independent predictor of adverse prognosis in bladder cancer even when the patient has no evidence of tumor in cystoscopy or cytology (10). In the present study we also determined serum and urine levels of TATI and trypsinogens, but no significant correlation between the protein levels and tumor stage and grade or disease-free interval was observed (data not shown).…”

Alpha-fetoprotein-producing transitional cell carcinoma of the urinary bladder: a case report

“…A serum level [200 ng/ml is highly indicative of HCC, but it is not an accurate single reference for diagnosis of the disease [13,14]. Pectasides et al retrospectively evaluated the serum tumor markers for TCC of the urinary bladder and concluded that AFP is not a useful marker for the diagnosis, response prediction, and monitoring of bladder TCC [15]. In this case, high AFP levels were detected in the serum, but a solid lesion was never found using abdominal ultrasonography and CT even after the disease had progressed.…”

Choroid Plexus Carcinoma Secreting Carbohydrate Antigen 19-9 in an Adult-Case Report-

“…CA19-9 is considered to be a serum marker for carcinomas in the gastrointestinal tract and pancreas, and is also found in carcinomas in the bladder, breast, kidney, and so on. 13,16,18) Therefore, in addition to histochemical studies, careful systemic examinations are indispensable to distinguish choroid plexus carcinoma from metastasis. In the present case, whole body examinations including scintigraphy and positron emission tomography found no evidence of a primary focus of metastasis.…”