Serum and Urinary Carbohydrate Antigen 19-9 in Ureteropelvic Junction Obstruction in Children
Purpose To investigate the role of serum, bladder urine and affected renal pelvis CA19-9 levels as a marker for surgery in UPJO. To examine the possible clinical application of urinary CA19-9 as a noninvasive diagnostic and predictive biomarker in management of UPJO. Material And Methods three groups of patients were included in this study. Group I, patients with sever UPJO admitted for surgery (18, mean age, 36.2 M). Group II patients with UPJO on conservative (20, mean age, 34.2 M)). Group III, fluid retrieve from hydroceles and renal cysts in MCDK. CA19-9 in serum, bladder urine and renal urine pelvis, hydrocele and renal cyst were measured and repeated 9 months post pyeloplasty. Moreover, apoptosis indices and sonographic hydronephrosis grading were evaluated during the time course. Results The CA19-9 level in the serum and voided urine and renal pelvis in group I, was significantly higher, 441.36±120.52 U/ml (normal up to 39 U/ml) than the 2 control groups. A significant decrease in the serum and urinary CA19-9 levels and mean anteroposterior renal pelvic diameter were noted in the 9th month after surgery. The CA19-9 level was below than normal value not only in control group but also surprisingly in renal cyst fluid in children with multicystic dysplastic kidney. Conclusions These data suggesting that CA19-9 in voided and pelvis urine per se is highly correlated with the severity of hydronephrosis, AP pelvic diameter, renal function and drainage curve in DTPA scan. Voided urine CA19/9 is highly sensitive, noninvasive, and clinically applicable marker in UPJO.