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Urinary levels of tumour associated antigens (CA 19-9, TPA and CEA) in patients with neoplastic and non-neoplastic urothelial abnormalities.

The urinary excretion of carbohydrate antigen 19-9 (CA 19-9), tissue polypeptide antigen (TPA) and carcinoembryonic antigen (CEA) was evaluated in 264 patients with bladder cancer. Cut-off levels were established using a pool of healthy blood donors. The combined determination of CA 19-9 and TPA had a sensitivity of 74% in pTa and 83% in pT1 tumours, and 62% in grade 1, well differentiated tumours. Absence of disease at follow-up was related to a significant decrease in CA 19-9 and TPA in 129 patients with superficial (pTa or pT1) bladder carcinoma, followed up for at least 3 years. Recurrences, defined as new tumours at the same site or elsewhere in the bladder, were associated with an increase in the mean values but this was not statistically significant. A poor prognosis was indicated in patients with infiltrating tumours and the following pre-operative levels: TPA > 1500 u/l or CA 19-9 > 300 u/ml or CEA > 50 ng/ml.