THE ROLE OF TUMOR MARKERS CA 125, CA 72-4 AND CA 19-9 IN DETECTION AND MONITORING OF THE COURSE OF DISEASE OF OVARIAN CARCINOMA AND CARCINOMA OF THE UTERINE BODY

Abstract

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.