[Advances regarding tumor markers in bladder cancer]. / Avances en marcadores tumorales en cáncer vesical.

INTRODUCTION: Currently, there is not known tumoral marker for vesical carcinoma that would allow to distinguish when a surface tumour may become invasive. OBJECTIVE: To analyze the functionality of a series of biological substances (CEA, CA 50, CA 19.9 and TPS) in vesical carcinoma. MATERIAL AND METHODS: Between September 1992 and June 1994, a total of 385 biological specimens divided into two groups were analyzed. The first group comprised 271 serum samples from 81 control subjects and 190 patients with vesical carcinoma. The second group included 114 urothelial tissue samples (56 controls and 58 vesical carcinoma). Serum and tissue levels of CA, CA 50, CA 19.1 and TPS were determined in both groups by fluoroimmunoassay, RIA and IRMA, respectively. An statistical evaluation was done using Student's 't' and/or Mann-Whitney tests depending on whether data distribution adjusted to normal or not. RESULTS: Patients with vesical carcinoma, ana within this group those with infiltrant tumours, showed higher CEA serum levels. Also CEA tissue levels found in neoplastic vesical urothelium were higher than those in the control group (p < 0.05). Tissue levels were higher in infiltrant tumours. Higher TPS serum and tissue levels were found in the vesical tumours group. Same as with CEA, CA 50 also exhibited higher serum levels in the group with vesical Ca than in the controls (p < 0.01). Likewise, CA 50 tissue values were higher in the group with vesical Ca, more specifically in the infiltrant tumours group (p < 0.001). Statistically significant differences become apparent when the above values were compared to tissue samples from the control group (p < 0.001). On the other hand, serum CA 19.9 levels were lower in the vesical carcinoma group although tissue levels were higher in the vesical Ca group (p < 0.001). CONCLUSIONS: Transitional cell vesical carcinoma is a tumour that produces and secretes CEA, CA 50, CA 19.1 and TPS. CEA and CA 50 levels could be used as prognostic factors.

[Diversions of the upper urinary tract] in oncologic patients]. / Derivaciones del tracto urinario superior en pacientes oncológicos.

Herein it is described the survival rate, the quality of life and the complications of the upper urinary tract diversion in 22 pluri-treated tumoral patients (both male and female, average 65.2 years old). Cancer etiology has been: colon-rectum neoplasia (36.3%), bladder carcinoma (36.3%), prostate carcinoma (9.9%), ovary cancer (4.5%), abdominal wall desmoid tumor (4.5%), pheochromocytoma (4.5%) and gastric carcinoma (4.5%). Urinary diversions type has been: percutaneous nephrostomy (40.9%), ureteral stent (31.8%), both (13.6%) and cutaneous ureterostomy (13.6%). Urinary diversions were performed unilateral in 90.9%. The average survival has been 4.8 months. The quality of life was poor in 68.1%. The following complications were observed: urinary infection (45.4%), hematuria (36.3%), diversion catheter lose (34.8%) and obstruction (27.2%). Urinary diversion in pluri-treated cancer patients must be carefully indicated to prevent negative aspects upon psychophysic and social activity of the patients.