The value of urinary cytology, serum and urinary carcinoembryonic antigen, rheumatoid factors, and urinary immunoglobulin concentration as tumor markers or prognostic factors in predicting progression of superficial bladder cancer.

Abstract

We followed 67 patients with superficial bladder cancer (TA, T1) for 12-48 months (mean, 26.8 months) after surgical removal of the tumors. Every 3-4 months, when the patients came for cystoscopic control, we evaluated serum and urinary carcinoembryonic antigen (CEA), urinary cytology, serum rheumatoid factors, and urinary IgG, IgA, and IgM concentrations. The purpose was to look for markers or prognostic factors in patients with superficial bladder carcinoma other than characteristics of the excised tumors themselves. We emphasized data that can be obtained on patient follow-up. Our results were correlated with tumor recurrence and tumor progression rates. In contrast with other reports, only urinary immunoglobulins (especially IgG) proved to have prognostic value. However, urinary CEA and (even more so) urinary cytology are fairly good tumor markers: they were positive when the bladder tumors were present and, in the case of recurrence, before recurrent tumors were visible.