Diagnostic value of serum tumor biomarkers for endometrial cancer in elderly women with intrauterine abnormalities on transvaginal ultrasound

Abstract

Objective To investigate age-related changes in serum tumor markers carbohydrate antigen 125(CA125), CA153 and CA199, and the clinical significance of separate and combined detection of these markers for screening endometrial carcinoma(EC)in elderly women with intrauterine abnormalities on transvaginal ultrasound(TVS). Methods Cross-sectional data of 420 elderly women suspected of having an intrauterine abnormality by TVS and undergone hysteroscopy with dilation and curettage from January 2010 to December 2017 were retrospectively analyzed.Patients were divided into a 60-64 years-old group and a 65-83 years-old group.Aging-related changes in positive rates of CA125, CA153 and CA199 were compared between the two groups.Differences in positive rates of tumor markers were compared between different pathological types.Using postoperative pathological diagnosis as the gold standard for EC, the diagnostic sensitivity, specificity and accuracy of serum CA125, CA153 and CA199 alone or in combination for EC were calculated. Results The positive rates of CA125, CA153 and CA199 were 3.9%(16/412), 0%(0/172)and 5.0%(20/404), respectively.The positive rate of CA125 was higher in the 65-83 years-old group(6.5%, 16/246)than in the 60-64 years-old group(0.0%, 0/166)(P=0.001). The positive rates of CA125 and CA199 in patients with EC were 14.3%(4/28)and 42.9%(12/28), which were higher than those in patients with other pathological types.However, the sensitivity of single and combined detection of CA125 and CA199 was too low for the diagnosis of EC(14%、43%). Conclusions The single and combined detection of CA125, CA153 and CA199 for screening EC is of limited value in elderly women.New tumor markers need to be identified and used in combination with TVS for screening EC in elderly women. Key words: Endometrial neoplasms; Transvaginal sonography; Tumor biomarker