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Urine carcinoembryonic antigen levels are more useful than serum levels for early detection of Bilharzial and non-Bilharzial urinary bladder carcinoma: Observations of 43 Egyptian cases Gamal M Saied1, Wafaa H El-Metenawy2, Mohamed S Elwan1 and Nazar R Dessouki*3 Address: 1Department of General Surgery, Faculty of medicine, Cairo University, Cairo, Egypt, 2Department of Radiation Oncology, Faculty of Medicine, Cairo University, Cairo, Egypt and 3Department of General Surgery, St. Bernard's Hospital, Gibraltar, UK Email: Gamal M Saied - [email protected]; Wafaa H El-Metenawy - [email protected]; Mohamed S Elwan - [email protected]; Nazar R Dessouki* - [email protected] * Corresponding author

Published: 15 January 2007 World Journal of Surgical Oncology 2007, 5:4

doi:10.1186/1477-7819-5-4

Received: 02 September 2006 Accepted: 15 January 2007

This article is available from: http://www.wjso.com/content/5/1/4 © 2007 Saied et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract Background: Both urinary bilharziasis and urothelial neoplasia are associated with increased production of tissue carcinoembryonic antigen (CEA). Patients and methods: Urine and serum CEA were determined in 43 patients with urinary bladder carcinoma including 22 post bilharzial and 21 nonbiharzial cases, in addition to 10 normal control cases. Results: A significant increase was detected in both urine and serum CEA levels with bladder carcinoma compared to control cases. Urinary CEA was significantly elevated in 86% of bilharzial, versus 62% in nonbilharzial bladder carcinoma. Only 10.5% of control cases had urinary CEA elevation. The mean urinary CEA in bilharzial, was higher than that of nonbilharzial carcinoma, but the difference was not statistically significant. There was a definite relationship between urine CEA and the stage of malignancy; the higher the stage, the higher the level of urine CEA. No relationship could be detected between the stage of malignancy and serum CEA, or between the grades of malignancy and urine or serum CEA levels. Conclusion: Urinary CEA is more useful than serum CEA in the early detection of urotherlial carcinoma particularly if provoked by bilharziasis. Its level is also correlated with the tumor stage.

Background Carcinoembryonic antigen (CEA) a specific product of neoplasia derived from the endoderm and is supposed to have a potential value in screening, diagnosis and followup of patients suspected of having urothelial carcinoma [1]. It has also been detected in other types of normal human tissue including prostate, uterus and spleen. This

aroused fears of false positive results and of compromising specificity if further enhancement of sensitivity was tried [2]. Urinary CEA measurement and cytological