The clinical value of urinary carcinoembryonic antigen-like substances in urothelial cancer.

Although there is a positive correlation between the concentration of urinary carcinoembryonic antigen-like substances and urothelial cancer the clinical value of this association is in doubt. Urinary carcinoembryonic antigen values have been determined in large numbers of specimens from patients with a variety of urologic diseases but most studies have recorded only single measurements at the time of diagnosis. We examined the role of carcinoembryonic antigen in urothelial malignancies by comparing serial carcinoembryonic antigen, and cytologic and histologic analyses done on simultaneously collected urine and tissue specimens. We were particularly interested in the value of carcinoembryonic antigen as a diagnostic adjunct to cytology in low grade carcinoma and dysplasia, and the role of serial measurements of this substance in followup. The results of 102 analyses in 48 patients during a 15-month period indicate that urinary carcinoembryonic antigen measurements have little value in the diagnosis of bladder cancer, are of limited usefulness in combination with cytologic studies and are poorly correlated with simultaneously determined cytologic and histologic findings. Although the initial results were not promising serial measurements may be useful in followup.