Clinical evaluation of urinary and serum carcinoembryonic antigen in bladder cancer.

Urinary carcinoembryonic antigen-like activity was increased (more than 1.5 ng. per ml.) in 61 per cent of patients with transitional cell carcinoma of the bladder. The frequency of abnormal carcinoembryonic antigen values correlated with the extent and the grade of the tumor. However, urinary tract infection can produce abnormal carcinoembryonic antigen values in non-cancer patients. The use of urinary carcinoembryonic antigen measurement and urine cytologic examination for diagnosis of transitional cell carcinoma gave a better diagnostic yield than did use of either test alone. In transitional cell carcinoma patients with abnormal preoperative urinary carcinoembryonic antigen values, postoperative urinary carcinoembryonic antigen values were useful for determining completeness of tumor resection. However, with total cystectomy and creation of an ileal conduit or ureterosigmoidostomy, urinary carcinoembryonic antigen values increased markedly postoperatively. Serum carcinoembryonic antigen values were of little value in the diagnosis of transitional cell carcinoma.