Abstract
A total of 190 patients being treated or followed up for urothelial carcinoma have been studied by the serial estimation of their urinary and plasma CEA levels. Only 46% of patients with a urothelial neoplasm present have a raised urinary CEA level. Infection or ileal conduit urine vitiate the result as they produce high CEA levels in the urine in the absence of any neoplastic disease. The accuracy of urinary CEA estimations is compared with that of cytology. Plasma CEA levels do not serve as a useful guide to the presence of extra-urinary tract tumour spread if taken as isolated readings. However, serial plasma CEA estimations may indicate that metastatic disease is present several months before its detection by the more usual clinical methods in a minority of patients.
Highlights
Summary.-A total of 190 patients being treated or followed up for urothelial carcinoma have been studied by the serial estimation of their urinary and plasma CEA levels
Further studies have shown that raised levels occur in association with a wide variety of malignant tumours of different histogenesis, including urothelial carcinomata, together with some benign inflammatory and regenerative disorders
Ileal conduit urine yields elevated levels of CEA, which precludes its use to assess the presence of further disease in the remaining urinary tract of such patients
Summary
The principal members of the study group are 190 patients (134 males and 56 females) who either had, or had had in the past, histologically proven urothelial carcinomata. Sixty-two per cent have been assessed for a period exceeding 12 months, and up to 24 months or over. 47 (33 males and 14 females) either had previously undergone cystectomy and ileal conduit diversion when first included in the study, or underwent this procedure during their period of observation. This high figure (22%) reflects the greater proportion of advanced disease seen at the Royal Marsden Hospital
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