Abstract
The value of tumor markers for diagnosis, evaluation of therapeutic effectiveness, and prognosis is attracting considerable attention. There is no easily evaluated and effective marker for bladder tumors, which constitute most of the tumors of the urinary and reproductive tracts. To determine the possibility of their application in the diagnosis of bladder tumors, 6 tumor markers were simultaneously measured at the time of diagnosis of bladder tumors. The subjects were 93 cases of bladder cancer, first diagnosed between the years 1973 and 1988, in whom the degree of invasion was clearly evident. There were 12 pTa, 50 pT1, 13 pT2, 10 pT3 and 8 pT4 cases. Controls were 22 cases of prostatic hypertrophy treated during the same period. Blood samples were obtained after fasting prior to treatment ; and CEA, ferritin, β2 microglobulin (β2Mg), AFP, immunosuppressive acidic protein (IAP) and tissue polypeptide antigen (TPA) were measured. There were no statistically significant differences between ferritin and AFP of any group. The CEA value for the prostatic hyperophy group was 1.4±0.5 ng/ml, which was significantly different from the 2.5±2.1 ng/ml value of the pT4 group. When the cut-off point was set at 1.0 ng/ml, which was the most efficient point, sensitivity and specificity were both 83%, which were the highest values for any of the markers. There were significant differences in β2-Mg between the pT4 group (2.8±0.3 mg/l) and the prostatic hypertrophy, pT2 and pT3 groups (2.0±0.7, 1.7±0.4 and 1.6±0.5 mg/l, respectively) . This indicated high values in advanced stages. There was no correlation between β2-Mg and creatinine in pT4 cases. There were significant differences in TAP (401±109 ug/ml) of prostatic hypertrophy cases, and that in pT2 (538±212 μg/ml), pT3 (697±459 μg/ml) and pT4 (629±192 μg/ml) . There were significant differences between pTa (408±127 μg/ml) and pT4, between pTl (423±189 μg/ml) and pT4, and between pT1 and pT3, indicating increased values in advanced stages. A significant difference was observation in TPA only between the prostatic hypertrophy group (109±31 U/l) and the pT4 group (155±71 U/l) . From the above, the sensitivity and specificity of CEA were highest. Thus when abnormally high levels are found, examination must be performed on the suspicion of bladder cancer. If TAP is abnormal, there is a possibility of advanced stage disease ; and if β2-Mg and TPA are abnormal the possibility of pT4 disease must be considered.
