Elevated tumour markers in patients with Balkan endemic nephropathy

Area of Science:

• Nephrology
• Oncology
• Biomarker Research

Background:

• Balkan nephropathy (BEN) is linked to urothelial cancer, often diagnosed at advanced stages.
• Early detection of urothelial cancer in BEN patients and their families is crucial.
• Tumour markers like CEA, TPA, and ferritin are investigated for diagnostic potential.

Purpose of the Study:

• To assess the utility of serum and urinary tumour markers (CEA, TPA, ferritin) for early urothelial cancer detection in BEN patients and relatives.
• To differentiate between BEN patients, BEN with renal failure (BEN-RF), healthy family members (HFM), glomerulonephritis (GN) patients, and healthy controls (C).

Main Methods:

• Serum and urinary levels of carcinoembryonic antigen (CEA) and tissue polypeptide antigen (TPA) were measured.
• Ferritin was also assessed as a potential marker.
• Patients included BEN (normal renal function), BEN-RF, HFM, GN, and C groups.
• A ten-year follow-up was conducted for urothelial cancer development.

Main Results:

• Serum CEA was elevated in BEN-RF patients compared to HFM.
• Serum TPA levels were significantly higher in BEN and BEN-RF patients than in controls and HFM.
• Urinary TPA levels were elevated in HFM, BEN, BEN-RF, and GN patients compared to controls.
• No urothelial cancer developed in any studied BEN patients during follow-up.

Conclusions:

• Urinary TPA elevation in various groups suggests it may not be a specific or reliable tumour marker for urothelial cancer in BEN.
• Further evaluation is needed to determine the clinical relevance of elevated TPA levels in BEN patients.
• Early detection strategies for urothelial cancer in BEN populations require further investigation.