scholarly journals Rational application of tumor marker CA 125 in gynecological oncology

2010 ◽  
Vol 63 (3-4) ◽  
pp. 195-199
Author(s):  
Srdjan Djurdjevic ◽  
Sanja Stojanovic ◽  
Marijana Basta-Nikolic ◽  
Marko Maksimovic

Introduction CA 125 determination started in 1981, when Bast et al. discovered monoclonal antibody OC-125 belonging to immunoglobulin G class (IgG1) using K?hler and Milstein's technique of hybridization. CA 125 antigen is produced in amniotic cells of the 7 week-old embryo, while in adults it can be detected in epithelium of most organs which originate from M?ller ducts. The upper level of referent values for CA 125 in serum is 35 U/mL and can be seen in about 99% of healthy people. Application of tumor marker CA 125 in gynecological oncology More than 83% of patients with epithelial ovarian carcinoma have elevated values of CA 125 higher than 35 U/mL at the moment of diagnosing the disease. In cases of ovarian carcinoma, preoperatively determined values of CA 125 in serum are correlated with the extent of the expansion of the disease , histological type of tumor and degree of differentiation of malignant cells. Elevated values up to 65 U/mL in serum can also be found in other malignant tumors (pancreas, breast, colon, bladder, lungs, liver) and in different benign diseases. The level of serum CA 125 after the surgery can indicate regression or progression of ovarian carcinoma in more than 90% of the patients who had had elevated values of CA125 prior to the surgery. Postoperative levels of CA 125 >35 U/mL in patients with no residual tumor and values >65 U/mL in those with residual tumor implants represent a separate prognostic factor in further course of the disease. Conclusion The importance of continuous determination of CA 125 tumor marker has to be adjusted to each single case.


2021 ◽  
Vol 14 (4) ◽  
pp. 156-160
Author(s):  
Nimrah Sultana ◽  
Shaista Shoukat ◽  
Sadaf Nausheen ◽  
Bakhtawar Memon

Background: Accurate evaluation of ovarian carcinoma is utmost important for effective management. PET/CT is reported to be effective in evaluation of suspected recurrence of ovarian carcinoma. This study aims to assess the accuracy of PET/CT in evaluation of recurrent ovarian cancer among clinically suspected cases with rising tumor marker or suspicious clinic-radiological findings. Patients and methods: This prospective cross-sectional study was conducted at Radiology department of Jinnah Postgraduate Medical Centre Karachi from 22nd April 2019 to 21st April 2020. Patients having age of 40 to 60 years and referred for PET scan with suspected recurrence of ovarian carcinoma were consecutively enrolled. Patients were suspected due to relevant history, clinical findings and initial imaging investigations with elevated CA-125 level. Results of 18FDG PET/CT scan was correlated with the raised tumor findings. The PET/CT scan showing abnormally elevated FDG take-up and higher SUV values than the background activity considered recurrence. Diagnostic accuracy of PET/CT was calculated taking raised tumor level as reference category. Results: Of 65 patients, median age was 50 (43-56) years. The findings showed positive cases in 57 (87.7%) while negative in 8 (12.3%) patients, whereas the findings of tumor marker showed raised tumor marker in 61 (93.8%) patients. Diagnostic accuracy of PET/CT showed sensitivity, specificity, positive predicted value, negative predated value, and overall diagnostic accuracy as 93.44%, 100%, 100%, 50%, and 93.85% respectively. Conclusion: A higher accuracy of PET/CT was observed in the diagnosis of recurrent ovarian cancer among clinically suspected cases, thus helping in devising an appropriate management plan by the treating physician.





2013 ◽  
Vol 20 (06) ◽  
pp. 904-908
Author(s):  
NASEER AHMED SHAIKH ◽  
RUKHSANA PARVEEN SAMO ◽  
M. QASIM MEMON

Object: 1). To analyze of serum tumor marker CA-125 in patients with ovarian malignant tumors. 2). To correlate betweenthe serum levels of tumor marker with histological types of ovarian malignant tumors. Study Design: Institution based descriptive andprospective study. Place & Duration: Department of Pathology, Liaquat University of Medical & Health Sciences, Jamshoro from January2009 to June 2011. Material & Methods: One hundred cases, diagnosed as ovarian malignant tumor on H&E staining were selected forstudy & measure serum CA-125 preoperatively and postoperatively in each case. Results: Out of 100 cases diagnosed as on H&E stainwere 33 serous cystadenocarcinoma, 24 mucinous adenocarcinoma, 10 germ cell tumors and 08 sex-cord stromal tumors. On serumanalysis increased level of CA-125 was seen preoperatively in 33/33 cases of serous cystadenocarcinoma and 24/29 cases of mucinousadenocarcinoma. Serum tumor marker value was declined following appropriate therapy of the tumors. Conclusions: Serum tumormarkers CA-125 is useful and important for the detection of ovarian tumors. It is most significant for serous cystadenocarcinoma. It mayalso help in prognosis and specific treatment of ovarian malignancies relating to histological type.



1993 ◽  
Vol 3 (5) ◽  
pp. 299-303 ◽  
Author(s):  
C. G. TropÉ ◽  
A. Ph. Makar ◽  
J. Kærn ◽  
G. B. Kristensen ◽  
I. Vergote ◽  
...  

Serum CA 125 was evaluated as a tumor marker in 85 patients with borderline ovarian tumors. Serum CA 125 levels were elevated preoperatively in 18 of 20 (90%) samples (median 66, range 5–272 U ml−1). Preoperative serum CA 125 levels did not correlate to FIGO stage. Preoperative serum CA 125 levels were elevated in seven of nine (78%) with serous tumors (median 131, range 5–272 U ml−1) and in all 11 with mucinous tumors (median 62, range 41–157 U ml−1). There was no significant difference in the CA 125 levels between these two histologic types. Postoperative serum CA 125 levels, measured 3–6 weeks after primary laparotomy, were significantly lower than the preoperative ones (P< 0.001). No difference in the postoperative CA 125 levels was found between those with and those without residual disease after surgery. Postoperative serum CA 125 levels were elevated in eight of 60 (13%) without residual tumor. None of these had relapsed at the time of analysis (26–87 months after surgery). Serum CA 125 levels tended to correlate with disease evolution during chemotherapy. Two with disease remissions had falling levels, one with stable disease had falling level and one with disease progression had rising level. Serum CA 125 samples were obtained before second-look laparotomy in seven patients. Two with negative findings at second-look had normal levels. Of five with positive findings at laparotomy only two had elevated serum CA 125 levels. Disease relapse was associated with elevated serum CA 125 levels in only one of six patients.



2019 ◽  
Vol 31 (4) ◽  
pp. 931-936
Author(s):  
Kristina Petkova ◽  
Venci Chalkov

Undoubtedly, nowadays the number of patients suffering from benign or malignant tumors is increasing. Particularly affected is the female population with ovarian cancer, carcinomas of the uterine body and non-inflammatory diseases of the ovary, the oviduct and the broad ligament and other benign conditions. Carcinoma is one of the most common causes of mortality in our country, as well as in the Balkans. In our country malignant tumors occupy third place in terms of total patients treated, after diseases of the respiratory and circulatory system. Due to the rapid increase in the number of patients with the following diagnoses: ovarian carcinoma, uterine carcinoma, non-inflammatory ovarian disease, oviduct, broad ligament and other benign conditions, their timely diagnosis is of great importance for the possibility of their treatment and reducing the percentage of mortality. When setting the diagnosis, tumor markers have an important role, whose elevated blood concentrations indicate changes of benign or malignant origin. Tumor markers are substances (proteins, enzymes, hormones, etc.) secreted in the body as a consequence of its response in the presence of a benign or malignant change. Their measurement and identification is useful for establishing the diagnosis, as well as for monitoring the course of the disease and the success of the therapy. Tumor markers are usually determined in blood, urine or tissue samples using specific, immunochemical laboratory methods. In the medical practice, about 30 different tumor markers are used, but in the diseases that are subject of our research commonly are used the following: CA 125, CA 72-4 and CA 19-9. Besides these tumor markers, as a new tumor marker, in this research project is mentioned HE4 (human epididymis protein 4). HE4 in combination with CA 125 assists in determining the type of tumor mass (benign or malignant), through algorithm for estimating the risk of ovarian cancer (Risk of Ovarian Malignancy Algorithm - ROMA). The goals of this paper are: regular control of healthy women and women who have an increased risk of developing carcinoma (family history), diagnosing carcinomas, estimating the prognosis of the disease (prognostic factor), and monitoring the course of the disease and the success of applied therapy (postoperatively) by determining the concentration of tumor markers CA 125, CA 72-4 and CA 19-9 in blood serum, in combination with other examinations (echo, swab, PAP test, Power color doppler, etc.). For the realization of these goals as a method of work, the concentrations of tumor markers CA 125 and CA 19-9 in blood serum were determined using the apparatus - Immulite 2000 which works on the principle of chemiluminescent method, as well as the determination of the concentration of tumor marker CA 72-4 in blood serum using an ELISA (enzyme linked immunosorbent assay) method. On the basis of the results obtained, we came to the conclusion that the concentrations of tumor markers CA 125, CA 72-4 and CA 19-9 in the blood serum increase in the occurrence of ovarian carcinoma, uterine carcinoma, non-inflammatory ovarian disease, the oviduct and broad ligament and other benign conditions, and that they are reduced postoperatively and with applied therapy, with the exception of patients who have metastases also on other parts of the body, where their concentrations are still rising or remain unchanged. Due to the outcome of these types of diseases, regular controls are recommended for the female population.



1997 ◽  
Vol 12 (3) ◽  
pp. 112-117 ◽  
Author(s):  
A. Gonzalez ◽  
F. Vizoso ◽  
J. Vázquez ◽  
A. Ruibal ◽  
J.L. Balibrea

In a prospective study we evaluated in 48 patients with primary ovarian carcinoma the prognostic value of the preoperative circulating serum levels of CA 125 and TAG-72. Serum levels of CA 125 were above the cutoff level of 35 U/ml in 68% of patients, TAG-72 levels were higher than 6 U/ml in 50% of patients, while the simultaneous use of the two markers increased the sensitivity to 75%. Pretreatment CA 125 and TAG-72 levels were significantly lower (p < 0.05, for both) in patients with well differentiated tumors than in those with moderate or poor differentiation. Similarly, both marker levels were significantly higher (p < 0.001) in patients with residual disease after cytoreductive surgery than in those with no residual tumor. In addition, the CA 125 levels were also higher in initial stages (I-II) than in more advanced stages (III-IV) (p < 0.05), whereas TAG-72 levels were higher (p < 0.05) in patients with mucinous or endometrioid tumors than in those with serous carcinomas. The results further indicated that high preoperative serum levels of CA 125 and TAG-72 were associated with a shorter overall survival (p < 0.001 and p < 0.01, respectively). Finally, separate Cox multivariate analysis showed that preoperative CA 125 and TAG-72 serum levels were, after stage, the strongest factors to predict overall survival (p < 0.0001, p < 0.05 and p < 0.005, respectively) in patients with ovarian carcinoma.



1987 ◽  
Vol 23 (3) ◽  
pp. 200-207 ◽  
Author(s):  
Yoshiyuki Negishi ◽  
Toshihito Furukawa ◽  
Takashi Oka ◽  
Masaru Sakamoto ◽  
Takao Hirata ◽  
...  


2005 ◽  
Vol 15 (2) ◽  
pp. 377-381
Author(s):  
D. Brasanac ◽  
I. Boricic ◽  
V. Todorovic ◽  
G. Basta-Jovanovic

The case of a 46-year-old female with umbilical metastasis as a first sign of an ovarian carcinoma is reported with the results of immunohistochemical analysis of primary tumor and lymph node and umbilical metastases. All specimens were positive for cytokeratin 7, CA 125, E-cadherin, alpha-, beta-, and gamma-catenin, as well as for MSH2. Staining with cytokeratin 20 and MLH1 was negative, and Ki-67 labeled from 5% (in the center of the lesions) to over 25% (at the periphery of the lesions) of the nuclei. Beta-catenin showed membranous positivity in the central parts and absence of staining at the periphery of ovarian tumor and umbilical metastasis, whereas lymph node metastasis presented with uniform reaction throughout. The results of immunohistochemical staining could point to the mechanisms employed by malignant tumors during invasion and growth of metastasis and suggest the possible role of the microenvironment in the expression of some adhesion molecules on tumor cells





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