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Clinical Value of Determination of Urokinase-type Plasminogen Activator Antigen in Plasma for Detection of Colorectal Cancer: Comparison with Circulating Tumor-associated Antigens CA 19-9 and Carcinoembryonic Antigen¹

Laboratory for Clinical Experimental Physiology [K. H., J. C. K., C. B., B. R. B.], and the Second Department of Gastroenterology and Hepatology [K. H., A. S., D. E.], University of Vienna, Vienna, Austria

We determined urokinase-type plasminogen activator antigen (u-PA), gastrointestinal cancer-associated antigen (CA 19-9), and carcinoembryonic antigen (CEA) in the plasma of patients with colorectal cancer at the time of clinical tumor detection and in a group of patients with Crohn's disease and analyzed the specificity of these tumor markers. u-PA, CA 19-9, and CEA were indicative for colorectal cancer in 75.5%, 51.5%, and 51.5% of tumor patients, respectively, with a specificity of 79.3%, 94%, and 97.5%. Sensitivity increased when two or all three markers were determined in identical blood samples, whereby a combination of u-PA and CEA exhibited the highest sensitivity value (90.9%) as compared to the combinations of u-PA and CA 19-9 or CA 19-9 and CEA. The use of all 3 markers did not lead to further increased sensitivity. False negative results were obtained in 3 of 32 cancer patients (9.1%, using one of 3 markers as indicative for malignant disease). These results indicate the benefit of multiparametric tumor marker analyses including u-PA antigen for the diagnosis of colorectal cancer.

¹ Supported by grants from the Austrian Federal Bank (P2330) and the Austrian Funds for the Promotion of Scientific Research (P8011).

² To whom requests for reprints should be addressed, at Laboratory for Clinical Experimental Physiology, Department of Medical Physiology, University of Vienna, Schwarzspanierstraße 17, A-1090 Vienna, Austria.

Received 5/11/92. Accepted 2/11/93.

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