Chuang Cheng-Keng, Liao Shuen-Kuei
Division of Uro-oncology, Department of Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Scand J Urol Nephrol. 2004;38(5):359-65. doi: 10.1080/00365590410015821.
Carbohydrate antigen 19-9 (CA19-9) is known to be a marker with a high positive rate in pancreatic cancer. There are limited data on the use of CA19-9 as a tumor marker in bladder carcinoma. We tested the expression of CA19-9 in transitional cell carcinoma (TCC) cell lines and bladder cancer patients to determine its usefulness in clinical applications.
The expression of CA19-9 was determined in six TCC cell lines and 42 bladder carcinoma tissues using two approaches: immunohistochemistry and enzyme immunoassay (EIA) analysis. EIA was used for testing CA19-9 levels in spent medium of cultured TCC cells and the urine of bladder tumor patients.
The CA19-9 value was low in spent media of the MGH-U1, MGH-U1R and MGH-U3 cell lines, but high in that of reactivity in MGH-U4 cells, while negative reactivity was found in high-grade MGH-U1 and MGH-U1R cells, both of which were derived from a stage B, grade 3 TCC. High incidences of negative CA19-9 staining were found in high-grade and invasive tumor tissues: 69.6% (16/23) and 70.8% (17/24), respectively. The sensitivity and specificity of urinary CA19-9 for detecting tumor recurrence were 83.3% and 50.8%, respectively. However, urinary tract infection also resulted in a high false-positive rate.
CA19-9 is promising for use as a biomarker for the detection and monitoring of low-grade and low-stage bladder cancer, with the proviso that patients to be tested should be free of infection.
碳水化合物抗原19-9（CA19-9）是已知的在胰腺癌中具有高阳性率的标志物。关于CA19-9作为膀胱癌肿瘤标志物的数据有限。我们检测了CA19-9在移行细胞癌（TCC）细胞系和膀胱癌患者中的表达，以确定其在临床应用中的效用。
采用免疫组织化学和酶免疫分析（EIA）两种方法，检测了6种TCC细胞系和42例膀胱癌组织中CA19-9的表达。EIA用于检测培养的TCC细胞的培养液上清和膀胱肿瘤患者尿液中的CA19-9水平。
MGH-U1、MGH-U1R和MGH-U3细胞系的培养液上清中CA19-9值较低，但MGH-U4细胞的反应性较高，而来源于B期3级TCC的高级别MGH-U1和MGH-U1R细胞呈阴性反应。在高级别和浸润性肿瘤组织中，CA19-9染色阴性的发生率较高，分别为69.6%（16/23）和70.8%（17/24）。尿CA19-9检测肿瘤复发的敏感性和特异性分别为83.3%和50.8%。然而，尿路感染也导致了较高的假阳性率。
CA19-9有望作为检测和监测低级别、低分期膀胱癌的生物标志物，但前提是待检测患者应无感染。
