title: Serum CA 19-9 as a good prognostic biomarker in patients with bladder cancer.
abstract: BACKGROUND
  Bladder cancer (BC) is the second leading malignant tumors of the genitourinary system. CA 19-9 has served as a diagnostic and prognostic marker for pancreatic carcinoma for years. In recent year, although a few studies have evaluated the roles of CA 19-9 in BC, the results are conflicting and the number of the patients studied is very small.
  
  
  OBJECTIVE
  To investigate the potential of serum CA 19-9 to serve as a diagnostic and prognostic marker of BC in a larger number of patients.
  
  
  METHODS
  A total of 272 (144 BC patients and 128 healthy subjects) were enrolled. Patients were followed-up routinely at 3-month intervals for 5 years. Serum CA 19-9 level was detected by ELISA.
  
  
  RESULTS
  CA 19-9 level was much higher than that in healthy subjects (43.69 ± 6.92 U/ml vs. 12.31 ± 4.39 U/ml, p < 0.001). However, when the value of 37 U/ml of serum CA 19-9 was used as the cut-off value for BC the sensitivity of CA 19-9 for BC was dropped to 38.8%. CA 19-9 was much higher in muscle invasive tumor subgroup than that in superficial tumor subgroup (38.09 ± 7.14 U/ml vs. 20.71 ± 4.15 U/ml, p < 0.027). CA 19-9 level was comparable in both subgroups (29.78 ± 5.07 U/ml vs. 26.13 ± 5.97 U/ml, p = 0.565). BC patients with more than 5 years survival time had lower serum CA 19-9 level than the rest (15.86 U/ml vs 46.68 U/ml, p < 0.001). Survival rate (>5 years) of patients with lower CA 19-9 levels (<29 U/ml) was significantly increased in comparison to those with elevated serum CA 19-9 levels (>29 U/ml) (p < 0.001).
  
  
  CONCLUSIONS
  serum CA 19-9 is not a good diagnostic maker, but a very powerful prognostic marker for BC. Such a study might be helpful for urologists to manage patients with BC.
authors: Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing 100730, China.
authors: Qing-hai
authors: QH
authors: Wang
authors: Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing 100730, China.
authors: Zhi-gang
authors: ZG
authors: Ji
authors: Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing 100730, China.
authors: Zhi-gang
authors: ZG
authors: Chen
authors: Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing 100730, China.
authors: Han-zhong
authors: HZ
authors: Li
authors: Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing 100730, China.
authors: Hua
authors: H
authors: Fan
authors: Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing 100730, China.
authors: Xin-rong
authors: XR
authors: Fan
authors: Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing 100730, China. Electronic address: shibbpumch@126.com.
authors: Bing-bing
authors: BB
authors: Shi
authors: Department of Microbiology & Immunology, Des Moines University, College of Osteopathic Medicine, Des Moines, IA 50312, USA; Department of Surgery, University of Missouri School of Medicine, Columbia, MO 65212, USA. Electronic address: yujiang.fang@dmu.edu.
authors: Yujiang
authors: Y
authors: Fang
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood*; D018395:CA-19-9 Antigen / Q000097:blood*; D006801:Humans; D009367:Neoplasm Staging; D011379:Prognosis; D015996:Survival Rate; D001749:Urinary Bladder Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000473:pathology
chemical_list: D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen
keywords: Bladder tumor; CA 19-9; Prognosis