Measurement of urinary CEA-like substance. An aid in management of patients with bladder carcinoma.

Urine and serum samples from patients with bladder carcinomas were studied for the occurrence of and variations in CEA content before, during, and after radiation therapy. The concentration of CEA-like substances in urine increased with a more advanced clinical stage of the tumor, although there were large intercase variations. In serum, slightly increased values were noted only in advanced cases. During radiation therapy, high CEA values were found at around mid-course. This could be related to a breakdown of tumor tissue. Judging from data for urine from radiation-treated prostatic carcinomas without known tumors in the bladder, radiation alone was not responsible for the elevation of CEA. Urinary infections contributed to raised levels of CEA-like substances in some cases. At the end of successful radiation therapy (as verified by cystoscopy, cytology, and clinical examination), 25 patients had CEA values in the urine comparable to normal values (14 +/- 7 ng CEA/ml). The decrease was significant from the initial values to those after radiotherapy (p less than 0.01). Four patients whose tumors persisted had high values (68 +/- 46 ng CEA/ml). In patients who had previously received radiation treatment for bladder carcinomas, CEA values were high in 20 with recurrences (58 +/- 36 ng CEA/ml) while they were lower in 13 who were free of recurrence (14 +/- 6 ng CEA/ml). These findings indicate that urinary CEA determinations may be used in the immediate followup and management of patients treated for bladder carcinoma. It also appears to be of prognostic significance.