Prognostic value of tissue-polypeptide specific antigen (TPS) in bladder cancer.

ABSTRACT

BACKGROUND: To evaluate, by means of a prospective study, the usefulness of tissue polypeptide specific antigen (TPS) as a tumor marker in follow-up and prognosis of bladder cancer. PATIENTS AND METHODS: A total of 438 subjects were included in the study and divided into three groups. The first group (n = 216) had active bladder cancer disease, the second group (n = 168) known bladder tumor disease but with no recurrence at the time of study, while the third group (n = 54) consisted of healthy volunteers. TPS in serum was measured using an EIA-kit, a solid phase two-site immunosorbent assay with polyclonal antibodies against cytokeratin 18. RESULTS: Serum TPS was significantly higher in patients with bladder tumors (p < 0.05). There was a significant correlation between TPS and stage (p < 0.05), presence of metastatic lymph nodes (p < 0.01), metastasis (p < 0.01), urinary cytology (p < 0.05), tumor shape (p < 0.01) and tumor size (p < 0.05). Grade, number of tumors, relapses and recurrences were not significantly correlated with serum TPS. With a TPS concentration of 100 U/L as the cut-off point, the sensitivity was 37% and the specificity 77%. With a 95% specificity, the sensitivity was 9%. CONCLUSION: Serum TPS is a marker for bladder carcinoma correlated with stage, urine cytology, tumor shape and size. Its clinical usefulness is not, however, established and it does not appear to be of use in the follow-up of patients with bladder tumor disease.