BACKGROUND.
Urothelial carcinoma is one of the most common malignant neoplasms of the urinary tract and is characterized by a high local recurrence rate. However, no specific and reliable tumor marker has been identified for the diagnosis and follow-up of patients with urothelial carcinoma.
METHODS.
Urinary basic fetoprotein (U-BFP) levels were measured by enzyme immunoassay in 119 patients with urothelial carcinoma, 64 patients with other urologic malignancies, 144 patients with benign diseases, and 166 healthy individuals to evaluate its clinical efficacy as a marker of urothelial carcinoma. The histologic localization of BFP was also studied. A cutoff value was set at 14 ng/mL based on the maximum diagnostic efficiency.
RESULTS.
The specificity and sensitivity of U-BFP for urothelial carcinoma was 91.7% and 58%, respectively. The U-BFP positive rate increased significantly with the histologic grade. The U-BFP positive rate was higher in both Tis and T2-4 than in Ta,1 disease. The U-BFP level exceeded the cutoff value before curative therapy in 32 patients; U-BFP was normalized in 97% of these patients within 2 weeks after therapy. There was a total of 11 recurrences and the U-BFP level returned to abnormally high levels in all instances. Histologic localization of U-BFP was dernonstrated in the cytoplasm of the tumor cells in 80% of the patients.
CONCLUSIONS.
Based on these results, U-BFP is a potential tumor marker of urothelial carcinoma. In particular, the test could be used to monitor patients whose U-BFP value is positive before therapy.