Tissue polypeptide antigen value in bladder washing material for follow up of patients with superficial transtitional cell carcinoma

Objective : to investigate the possible contribution of tissue polypeptide antigen value of the bladder of the bladder washing material, using the TPA-IRMA (Sangtec, Bromma, Sweden) as well as the TPS-IRMA (Beki AB, Bromma, Sweden), in the follow up of patients with superficial transitional cell carcinoma (TCC) of the bladder. Materials and Methods : The patients were divided into two groups : out patient department (OPD) group consisted of patients who would undergo cytoscopy examination as regular follow up without any suspicious signs for tumor recurrence and operating room (OR) group which consisted of patients with signs of tumor recurrence who would have cytoscopy under anaesthesia and tumor resection or bladder biopsy. Tissue polypeptide antigen value were determined in bladder washing material from patients with superficial transitional cell carcinoma of the bladder using both the polyclonal antibody (TPA) and M3 monoclonal antibody (TPS) immunoradiometric assay kit. Clinical and pathological findings were compared with TPA and TPS values, which threshold was determined at 2000 U/L. Results : The OPD group had low tumor incidence, and the sensitivity values detection of tumor recurrence were 53%, 50% and 56% for TPA, TPS and combined TPA and TPS test respectively. In the OR group of which the tumor incidence were between 66%-76%, the sensitivity values for detection of a recurrent tumor were 76%, 81% and 88% for TPA, TPS and combined TPA and TPS test respectively. In total patients from OPD and OR group, again the combination of TPA and TPS test gave the best sensitivity (78%) to predict the tumor recurrence. However, we found that the value of these markers did not correlate with the grade or stage of the tumor,. Conclusions : This study indicates that TPA and TPS values determined in bladder washing materials from patients with a history of superficial TCC can be useful for the clinical follow up of this disease as an additional tool to detect the tumor recurrence.