Carcinoembryonic antigen and beta-human chorionic gonadotropin as serum markers for advanced urothelial malignancies.

Serum levels of carcinoembryonic antigen and beta-subunit of human chorionic gonadotropin were measured in 92 patients with advanced urothelial malignancies referred to us for chemotherapy. Elevations of carcinoembryonic antigen and/or beta-human chorionic gonadotropin occurred in 60 of the 92 patients (65 per cent). Minimal elevations (less than 50 per cent above the normal range) occurred in 25 patients (27 per cent), while 35 (38 per cent) had significant elevations (more than 50 per cent above the normal range). Of the latter patients carcinoembryonic antigen alone was elevated in 16 (17 per cent), beta-human chorionic gonadotropin alone in 13 (14 per cent) and both in 6 (6 per cent). Among the 24 patients with initially elevated levels whose markers were re-evaluated during therapy the marker levels correlated with disease course in all 15 whose elevations were more than 50 per cent and in 4 of 9 with minimal elevations. In patients with adenocarcinoma of the bladder the carcinoembryonic antigen level frequently was elevated (9 of 10). We conclude that serum levels of carcinoembryonic antigen or beta-human chorionic gonadotropin are significantly elevated (more than 50 per cent above the normal range) in 38 per cent of the patients with advanced urothelial malignancies and can be used as tumor markers, since they correlate with the clinical course of the patient and the response to therapy. Serum carcinoembryonic antigen levels usually are elevated in patients with bladder adenocarcinoma.