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Clinical value of determination of urokinase-type plasminogen activator antigen in plasma for detection of colorectal cancer: comparison with circulating tumor-associated antigens CA 19-9 and carcinoembryonic antigen.

We determined urokinase-type plasminogen activator antigen (u-PA), gastrointestinal cancer-associated antigen (CA 19-9), and carcinoembryonic antigen (CEA) in the plasma of patients with colorectal cancer at the time of clinical tumor detection and in a group of patients with Crohn's disease and analyzed the specificity of these tumor markers. u-PA, CA 19-9, and CEA were indicative for colorectal cancer in 75.5%, 51.5%, and 51.5% of tumor patients, respectively, with a specificity of 79.3%, 94%, and 97.5%. Sensitivity increased when two or all three markers were determined in identical blood samples, whereby a combination of u-PA and CEA exhibited the highest sensitivity value (90.9%) as compared to the combinations of u-PA and CA 19-9 or CA 19-9 and CEA. The use of all 3 markers did not lead to further increased sensitivity. False negative results were obtained in 3 of 32 cancer patients (9.1%, using one of 3 markers as indicative for malignant disease). These results indicate the benefit of multiparametric tumor marker analyses including u-PA antigen for the diagnosis of colorectal cancer.