SERUM TUMOR-MARKERS AFTER RENAL-TRANSPLANTATION

The overall incidence of malignancy in renal transplant recipients is 100-fold higher compared with age matched controls. Routine clinical e valuation therefore often includes the determination of serum tumor ma rkers AFP, CA19-9, CEA, CA125, CA15-3, PSA, and calcitonin. We evaluat ed the specificity and the sensitivity of these markers in 575 renal a llograft recipients. Specificity varied between 0.69 (CA 125) and 0.96 (PSA) in 532 patients without cancer. Cyclosporine therapy and excret ory allograft function did not affect marker concentration; impaired l iver function was associated with significantly elevated AFP, CA19-9, CA125, and CA15-3 levels. In 43 patients with malignancies the sensiti vity of the markers ranged between 0.2 (CEA) and 1 (CA 125, CA 15-3). We therefore conclude that routine screening of the transplant populat ion with serum tumor markers is not useful because of the low sensitiv ity and specificity of these tests.