URINARY BASIC FETOPROTEIN IN THE DIAGNOSIS AND FOLLOW-UP OF PATIENTS WITH UROTHELIAL CARCINOMA

BACKGROUND, Urothelial carcinoma is one of the most common malignant n eoplasms of the urinary tract and is characterized by a high local rec urrence rate. However, no specific and reliable tumor marker has been identified for the diagnosis and follow-up of patients with urothelial carcinoma. METHODS, Urinary basic fetoprotein (U-BFP) levels were mea sured by enzyme immunoassay in 119 patients with urothelial carcinoma, 64 patients with other urologic malignancies, 144 patients with benig n diseases, and 166 healthy individuals to evaluate its clinical effic acy as a marker of urothelial carcinoma. The histologic localization o f BFP was also studied. A cutoff value was set at 14 ng/mL based on th e maximum diagnostic efficiency. RESULTS, The specificity and sensitiv ity of U-BFP for urothelial carcinoma was 91.7% and 58%, respectively. The U-BFP positive rate increased significantly with the histologic g rade. The U-BFP positive rate was higher in both Tis and T2-4 than in Ta,1 disease. The U-BFP level exceeded the cutoff value before curativ e therapy in 32 patients; U-BFP was normalized in 97% of these patient s within 2 weeks after therapy. There was a total of 11 recurrences an d the U-BFP level returned to abnormally high levels in all instances. Histologic localization of U-BFP was demonstrated in the cytoplasm of the tumor cells in 80% of the patients. CONCLUSIONS, Based on these r esults, U-BFP is a potential tumor marker of urothelial carcinoma. In particular, the test could be used to monitor patients whose U-BFP val ue is positive before therapy. (C) 1996 American Cancer Society.