Abstract
Balkan nephropathy (BEN) is commonly associated with urothelial cancer. Urothelial cancer is manifested in the advanced stage of disease. The aim of this study was to facilitate early detection of urothelial cancer in BEN patients and their family members living in an endemic region by using tumour markers, carcinoembryonic antigen (CEA) and tissue polypeptide antigen (TPA), and a putative marker, ferritin. Fifteen BEN patients with normal renal function, 17 with renal failure (BEN-RF), 13 healthy members of their families (HFM), 14 patients with glomerulonephritis (GN) and 12 healthy controls (C) were studied. Serum CEA levels in BEN patients were within normal limits, however, in BEN-RF patients they were significantly increased over HFM (p<0.05). Serum TPA levels in BEN and BEN-RF patients were significantly higher than in the C and HFM groups (p<0.05). Urinary CEA was not significantly different between the groups studied. Urinary TPA levels in HFM (median 125 U/1, BEN (236 U/l) and BEN-RF (275 U/l) were significantly increased over C (30 U/l), however, TPA levels were increased also in GN patients (437 U/l). None of the BEN patients studied developed urothelial cancer during the ten years' follow-up. Markedly elevated urinary TPA-like levels in all patients studied (HFM, BEN, BEN-RF, GN) suggest that urinary TPA may not be a reliable tumour marker. However, the clinical relevance of high TPA levels in BEN patients should be evaluated.
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References
Stefanović, V., Polenaković, M.: Balkan nephropathy. Kidney disease beyond the Balkans?Am. J. Nephrol., 11, 1 (1991).
Petković, S., Mutavdžić, M., Petronić, V., Marković, V.: Les tumeurs du bassinet et de l'uretère. Recherches cliniques et etiologiques.J. Urol. Nephrol., 77, 429 (1971).
Chernozemsky, I. N., Stoyanov, I. S., Petkova-Bocharova, T. K., Nicolov, I. G., Draganov, I. V., Stoichev, I. I., Tanchev, Y., Naidenov, D., Kalcheva, N. D.: Geographic correlation between the occurrence of endemic nephropathy and urinary tract tumours in Vratza District, Bulgaria.Int. J. Cancer, 19, 1 (1977).
Mihajlov, T.: Family grouping of excretory system tumors of patients with Balkan endemic nephropathy. In: Strahinjić, S., Stefanović, V. (eds): Current Research in Endemic (Balkan) Nephropathy 1983, University Press, Niš 1983, p. 249.
Čukuranović, R., Ignjatović, M., Stefanović, V.: Urinary tract tumors, and Balkan nephropathy in the South Morava River basin.Kidney Int., 40, Suppl. 34, S-80 (1991).
Valz, G., Kunžendorf, U., Keller, F., Offermann, G.: Elevated tumor markers in hemodialysis patients.Am. J. Nephrol., 8, 187 (1988).
Hall, R. R., Laurence, D. J. R., Darcy, D., Stevens, U., James, R., Roberts, S., Neville, A. M.: Carcinoembryonic antigen in the urine of patients with urothelial carcinoma.Br. Med. J., iii, 605 (1975).
Guinan, P., Dubin, A., Bush, I., Alsheik, H., Ablin, R. J.: The CEA test in urologic cancer: An evaluation and a review.Oncology, 32, 158 (1975).
Wahren, B., Edsmyr, F.: Carcinoembryonic antigen in serum, urine and cells of patients with bladder carcinoma.Urol. Res., 6, 221 (1978).
Fleisher, M., Grabstald, H., Whitmore, W. F., Pinsky, C. M., Oettgen, H. F., Schwartz, M. K.: The clinical utility of plasma and urinary carcinoembryonic antigen in patients with genitourinary disease.J. Urol., 117, 635 (1977).
Stefanović, V., Ignjatović, M.: Tumor, serum and urine carcinoembryonic antigen in upper urinary tract urothelial cancer.Nuc. Compact, 18, 230 (1987).
Bakić, M., Stefanović, V., Strahinjić, S., Savić, V., Slavković, A., Antić, S.: The study of anemia in patients with endemic (Balkan) nephropathy. In: Strahinjić, S., Stefanović, V. (eds). Current Research in Endemic (Balkan) Nephropathy 1983. University Press, Niš 1983, p. 89.
Oehr, P., Hamann, D., Klar, R., Schlosser, T., Winkler, C.: Serumkonzentrationen von Tissue Polypeptide Antigen und Tennessee Antigen im Vergleich zu CEA, AFP und ß-HCG bei Patienten mit Harnblasen-und Hodencarcinomen.Nuc. Compact, 11, 223 (1980).
Mross, K. B., Wolfrum, D. I., Rauschecker, H.: Determination of tissue polypeptide antigen (TPA) levels in different cancer types and controls.Oncology, 42, 288 (1985).
Putzki, H., Student, A., Breucker, K., Jablonski, M.: Reaction of the tumor markers CEA and TPA to a surgical trauma.J. Surg. Oncol., 33, 18 (1986).
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Stefanović, V., Ilić, S., Ignjatović, I. et al. Elevated tumour markers in patients with Balkan endemic nephropathy. International Urology and Nephrology 30, 621–626 (1998). https://doi.org/10.1007/BF02550557
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DOI: https://doi.org/10.1007/BF02550557