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Carcino embryonic antigen in patients with urologic cancer 2. the clinical utility of plasma carcino embryonic antigen and urinary carcino embryonic antigen like substance in urothelial cancer



Carcino embryonic antigen in patients with urologic cancer 2. the clinical utility of plasma carcino embryonic antigen and urinary carcino embryonic antigen like substance in urothelial cancer



Acta Urologica Japonica 27(3): 231-241



Determinations were made of plasma CEA [carcinoembryonic antigen] in 124 bladder cancer and 26 renal pelvic and ureteral cancer patients and of urinary CEA in 86 bladder cancer patients by radioimmunoassay (zirconylphosphate-gel). Cases showing plasma CEA levels of 6 ng/ml or above were regarded as CEA-positive. Bladder cancer patients (54) who were followed up for more than 6 mo. after surgery were divided into 2 groups, with and without recurrence. Plasma CEA levels determined before and 1 mo. after the operation were compared between the 2 groups. Of 16 cases labeled as positive for plasma CEA at 1 mo. after operation, 15 (94%) had a recurrence postoperatively. Of 38 cases categorized as plasma CEA-negative postoperatively, no more than 16 (26%) had a recurrence. Plasma CEA levels were studied in relation to smoking habit. Urothelial cancer patients whether smokers or nonsmokers showed a significantly higher positivity rate of plasma CEA than benign disease patients (P < 0.01). Urinary CEA levels tended to be higher in females than in males. Even benign disease patients exhibited abnormally elevated urinary CEA levels in the presence of urinary tract infection, with a positivity rate in excess of 60%. Plasma CEA as determined by immunoassay provides a useful means of assessing the efficacy of surgical treatment, determining the likelihood of recurrence and the presence or absence of metastasis and evaluating prognosis in patients with urothelial cancer. Further immunochemical studies seem to be indicated for the clarification of what is called urinary CEA-like substance, which is thought to be related to bladder cancer.

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