Determination of cancer antigen 125 in ovarian carcinoma

The clinical scenario of a female patient with a pelvic mass, elevated CA125 tumour marker, pleural effusion and ascites is often associated with malignancy. However, not all cases are malignant. Non-malignant diseases, such as Meigs syndrome and pseudo-Meigs syndrome, must be part of your differential. We present a 56-year-old woman with dyspnoea secondary to a right pleural effusion. After further investigations, a serum cancer antigen-125 was found to be elevated at 437.3 U/mL. CT of her abdomen and pelvis showed a large heterogeneous mass in the pelvis measuring 13.2×9.7×15.1 cm with mild ascites. She was initially thought to have ovarian carcinoma and underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy with omental biopsy. Pathology from the surgical specimen revealed a hydropic leiomyoma and after removal of pelvic mass her pleural effusion and ascites completely resolved. She was ultimately diagnosed with the rare pseudo-Meigs syndrome.

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An enzyme immunoassay procedure for cancer antigen 125 evaluated.

Clinical Chemistry ◽

10.1093/clinchem/34.12.2513 ◽

1988 ◽

Vol 34 (12) ◽

pp. 2513-2516 ◽

Cited By ~ 8

Author(s):

K W Ryder ◽

T O Oei ◽

M T Hull ◽

M M Sample

Keyword(s):

Positive Result ◽

Ovarian Carcinoma ◽

Receiver Operating Characteristic ◽

Enzyme Immunoassay ◽

Operating Characteristic ◽

Ca 125 ◽

Decision Threshold ◽

Cancer Antigen 125 ◽

Cancer Antigen ◽

Receiver Operating Characteristic Curves

Abstract The performance of a new enzyme immunoassay (EIA) procedure (Abbott Labs.) for cancer antigen 125 (CA 125) met or exceeded the manufacturer's claims for all analytical variables examined. Overall correlation with results obtained with a radioimmunoassay (RIA) were good. However, near the decision thresholds typically chosen to define a positive result for ovarian carcinoma, EIA results were 10 to 20 arbitrary units/mL less than the RIA results. At specific decision thresholds, therefore, the sensitivities and specificities of the EIA and RIA procedure differed. Adjusting the decision thresholds gave a similar optimum efficiency for each procedure: EIA, 82.9% (decision threshold, 35 units/mL); RIA, 83.4% (decision threshold, 54 units/mL). Receiver-operating characteristic curves showed that the two procedures' ability to distinguish patients with active ovarian carcinoma from those with disease in remission was the same.

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Endometriosis-Associated Ovarian Cancer: Population Characteristics and Prognosis

International Journal of Gynecological Cancer ◽

10.1097/igc.0000000000001317 ◽

2018 ◽

Vol 28 (7) ◽

pp. 1251-1257 ◽

Cited By ~ 9

Author(s):

Amilcar Barreta ◽

Luis Sarian ◽

Amanda Canato Ferracini ◽

Larissa Eloy ◽

Angelo Borsarelli Carvalho Brito ◽

...

Keyword(s):

Ovarian Carcinoma ◽

Good Prognosis ◽

International Federation ◽

Population Characteristics ◽

Advanced Stage ◽

Cancer Antigen 125 ◽

Cancer Antigen ◽

Gynecology And Obstetrics ◽

Endometrioid Ovarian Carcinoma ◽

Advanced Stages

ObjectiveThe aim of this study was to analyze and compare the clinicopathologic features and prognosis of clear cell ovarian carcinoma (CCOC) and endometrioid ovarian carcinoma (EOC) associated or not with endometriosis.MethodsThis was a reconstituted cohort study from a single-institution Brazilian cancer center approved under review board no. 68150617.7.0000.5404 with 50 patients with CCOC and EOC diagnosed between 1995 and 2016, followed up until 2017. Clinicopathologic characteristics and survival outcomes were analyzed.Result(s)There were 23 women (46%) with CCOC and 27 with EOC (54%); 80% of those women had histologic confirmation of endometriosis; 42% were nulliparous, and 42% were premenopausal; and cancer antigen 125 was elevated in both International Federation of Gynecology and Obstetrics stages I–II disease (mean, 614.7 Ui/mL; range, 3–6030 Ui/mL) or International Federation of Gynecology and Obstetrics stages III–IV disease (mean, 2361.2 Ui/mL; range, 8–12771 Ui/mL). Women with EOC were 7 years younger than those with CCOC. When associated with endometriosis, CCOCs were more likely diagnosed at earlier stages. Endometrioid ovarian carcinoma and CCOC at initial stage and EOC at advanced stage share similar good prognosis. Univariate analysis showed that CCOC not associated with endometriosis has worse overall survival (OS). However, multivariate analysis showed that only abnormally elevated levels of cancer antigen 125 and advanced stage at diagnosis were significantly associated with reduced progression-free survival. Tumor stage remains the only prognostic factor for OS.ConclusionsThe presence of coexisting endometriosis did not change the prognosis of EOC but was associated with better OS in patients with CCOC. Patients with CCOC and EOC at initial stages and EOC at advanced stages have a good prognosis; however, CCOC at advanced stages had a sooner recurrence and shorter OS.

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