Value Of Serum CA Research Articles

血清CEAとCA19-9が高値を示した十二指腸原発GISTの1例

血清CEAとCA19-9が高値を示した十二指腸原発GISTの1例

Prognostic value of serum CA-125 in patients with advanced epithelial ovarian cancer followed by complete remission after adjuvant chemotherapy

ObjectiveThe aim of this study was to evaluate the prognostic value of serum CA-125 in advanced epithelial ovarian cancer with complete remission after primary adjuvant chemotherapy.MethodsWe reviewed the records of 120 patients with advanced epithelial ovarian cancer who underwent primary surgery followed by adjuvant therapy at our institution between January 1998 and December 2005.ResultsThe median progression free survival was 21.6 months and 12.5 months in patients with nadir CA-125 levels ≤10 U/mL and 10 to 35 U/mL, respectively. Median overall survival in the same respective order was 130.2 months and 35.3 months. The level of serum CA-125 after the first cycle of adjuvant chemotherapy was most significantly higher in the recurrent group compared with the non-recurrent group. The optimal cut point of CA-125 on the receiver operating characteristic curve was 35 U/mL. Median progression free survival was 64.6 months and 12.8 months in patients with nadir CA-125 levels ≤35 U/mL and >35 U/mL, respectively, after first cycle of adjuvant chemotherapy.ConclusionSerum CA-125 level after the first cycle of adjuvant chemotherapy is a strong independent prognostic factor for advanced epithelial ovarian cancer with complete response.

Longitudinal Screening Algorithm That Incorporates Change Over Time in CA125 Levels Identifies Ovarian Cancer Earlier Than a Single-Threshold Rule

Longitudinal algorithms incorporate change over time in biomarker levels to individualize screening decision rules. Compared with a single-threshold (ST) rule, smaller deviations from baseline biomarker levels are required to signal disease. We demonstrated improvement in ovarian cancer early detection by using a longitudinal algorithm to monitor annual CA125 levels. We retrospectively evaluated serial preclinical serum CA125 values measured annually in 44 incident ovarian cancer cases identified from participants in the PLCO (Prostate Lung Colorectal and Ovarian) Cancer Screening Trial to determine how frequently and to what extent the parametric empirical Bayes (PEB) longitudinal screening algorithm identifies ovarian cancer earlier than an ST rule. The PEB algorithm detected ovarian cancer earlier than an ST rule in a substantial proportion of cases. At 99% specificity, which corresponded to the ST-rule CA125 cutoff ≥ 35 U/mL that was used in the PLCO trial, 20% of cases were identified earlier by using the PEB algorithm. Among these cases, the PEB signaled abnormal CA125 values, on average, 10 months earlier and at a CA125 concentration 42% lower (20 U/mL) than the ST-rule cutoff. The proportion of cases detected earlier by the PEB algorithm and the earliness of detection increased as the specificity of the screening rule was reduced. The PEB longitudinal algorithm identifies ovarian cancer earlier and at lower biomarker concentrations than an ST screening algorithm adjusted to the same specificity. Longitudinal biomarker assessment by using the PEB algorithm may have application for screening other solid tumors in which biomarkers are available.

The role of novel biomarker HE4 in endometrial cancer: a case control prospective study

The aim of the study was to explore the clinical value of serum human epididymis secretory protein E4 (HE4) and CA125 in endometrial carcinoma. From January 2010 to April 2012, serum specimens were collected from consecutive cases of endometrial carcinoma and from cases of uterus benign disease (control group). The CA125 normal value is considered less than 35U/mL. Two HE4 cutoff are considered: less than 70pmol/L and less than 150pmol/L. The specificity analysis was performed using the Mann-Whitney test for the CA125 and HE4 series. The level of statistical significance is set at p < 0.05. The sensitivity of CA125 in detecting endometrial cancer is 19.8%, whereas the sensitivity of HE4 is 59.4 and 35.6% for 70 and 150pmol/L cutoff, respectively. Thus the specificity of HE4 is 100% (positive predictive value = 100%, negative predictive value = 71.52 and 61.31% considering the two HE4 cutoff, respectively), whereas the CA125 specificity is 62.14% (positive predictive value = 33.9%, negative predictive value = 44.14%) in detection of endometrial cancer. Combining CA125 and HE4, the sensitivity to detect endometrial cancer is 60.4 and 34.6%, at HE4 cutoff of 70 and 150pmol/L, respectively, with a specificity of 100%. HE4 may be a new tool for preoperative evaluation and postoperative surveillance of endometrial cancer patients, with a positive predictive value = 100%. HE4 at cutoff of 70pmol/L yields the best sensitivity and specificity.

Urinary Concentrations of Human Epidydimis Secretory Protein 4 (He4) in The Diagnosis of Ovarian Cancer: A Case-Control Study

To analyze differential diagnostic accuracy of urinary human epidydimis secretory protein 4 (HE4) in patients with ovarian tumors. In the case-control study 23 patients with ovarian cancer, 37 patients with benign ovarian tumors and 18 women in the control group were included. Serum CA125 values and urinary concentrations of HE4were assessed quantitatively. Urinary creatinine concentrations and glomerular filtration rate were also determined and used to calculate ratios to HE4. Higher urinary HE4 concentrations were observed in patients with late stage ovarian cancer (p=0.001) and also in patients with early stage ovarian cancer when compared to patients with benign ovarian tumors (p=0.044). On analysis where all ovarian cancer patients were included, higher diagnostic accuracy was observed with calculated ratio of HE4 to glomerular filtration rate (GFR) to unchanged urinary HE4 concentrations -AUC 0.861 vs. 0.858. When discriminatory accuracy was calculated for urinary HE4/GFR ratio and unchanged urinary HE4 concentrations, the last demonstrated a higher area under the curve - 0.701 vs. 0.602. The urinary HE4/creatinine ratio had lower discriminatory characteristics than unchanged concentrations of urinary HE4. However, HE4 serum concentration was more accurate for discrimination of patients with benign and malignant ovarian tumors when compared to urinary HE4 and CA125 in sera (AUCs were 0.868 for serum HE4 and 0.856 and 0.653 for urinary HE4 and CA125, respectively). Ovarian cancer patients have higher urinary concentrations of human epidydimis secretory protein 4 than patients with benign ovarian tumors. Urinary HE4 has comparable discriminatory accuracy with serum HE4 for benign and malignant ovarian tumors and can be recommended as a non-invasive ovarian cancer risk assessment method.

Co-treatment of dichloroacetate, omeprazole and tamoxifen exhibited synergistically antiproliferative effect on malignant tumors: in vivo experiments and a case report.

Omeprazole (OPZ) and tamoxifen (TAM) strengthen the effects of anticancer drugs and dichloroacetate (DCA) inhibits tumor growth. This study assesses the synergistic effects of these drugs. HT1080 human fibrosarcoma cells and WI-38 human fibroblasts were used as test and control cells, respectively. DCA, OPZ and TAM alone or in combination were applied and cells were counted after a one week culture. The combination of these drugs was prescribed to a cholangiocarcinoma patient and serum CA19-9 was monitored. DCA combined with OPZ and TAM exhibited more potent antitumor activity than DCA alone in HT1080 fibrosarcoma cells, but did not influence proliferation of WI-38 human fibroblasts. All these drugs induce caspase-dependent cell growth inhibition through superoxide production. Since they can be taken orally and have been used clinically without major side effects, it was thought that this combination therapy would be a readily translated strategy to treat malignant tumors. Under the patient's consent these three drugs were prescribed to a 51-year old female cholangiocarcinoma patient to whom neither gemcitabine+S-1 nor adoptive immunotherapy with natural killer cells was effective. Disease progression was successfully blocked (the rise of serum CA19-9 value) for three months, also confirmed by CT. Although findings are preliminary, this study is a sample of translational research. Since there is no consensus regarding treatment strategy of cholangiocarcinoma and chemotherapy has only limited efficacy, it is expected that it might open a new possibility of treatment.

Abstract 1701: Clinical significance of serum and tissue Dickkopf-1 in patients with gastric cancer

Abstract Background: Dickkopf-1 (DKK-1) is a secreted protein known as a negative regulator of the Wnt signaling pathway and involved in embryonic development and tumorigenesis. Clinical significance of serum DKK-1 and tissue DKK-1 expression in gastric cancer has not been clarified. Methods: Serum concentrations of DKK-1 were assessed by enzyme-linked immunosorbent assay in 153 gastric cancer patients and 33 healthy controls. We also obtained serum CEA (ng/mL) and CA19-9 (U/mL) values by chemiluminescence immunoassay. For tissue DKK-1, we performed immunohistochemical staining for DKK-1 in 144 cancer specimens of 153 patients and in additional 265 consecutive gastric cancer specimens. Results: Serum DKK-1 concentrations were significantly higher in gastric cancer patients (56.27 pg/mL) than in healthy controls (30.50 pg/mL, p=0.018). With 36.3150 pg/mL of cut-off value, sensitivity and specificity for gastric cancer diagnosis were 80.4% and 78.8%, respectively. Gastric cancer patients with a serum DKK-1 of 60.0 pg/mL or higher had a significantly diminished survival compared with patients whose serum DKK-1 were lower (p=0.033). By immunohistochemistry, DKK-1 overexpression in cancer specimens was significantly correlated with increased serum DKK-1 concentrations (correlation coefficient, 0.395; p&amp;lt;0.001). The cancer patients with DKK-1 overexpression had a significantly worse prognosis than the patients without DKK-1 expression in this cohort (p=0.004) and additional consecutive cases (p=0.030). By multivariate Cox regression model, DKK-1 expression status predicted patient prognosis independently of pTNM stage and histologic differentiation in consecutive cases (p=0.018). Conclusion: Increased serum DKK-1 concentrations and overexpression of DKK-1 in gastric cancer tissue may contribute to diagnosing gastric cancer and predicting cancer patient outcome. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 1701. doi:1538-7445.AM2012-1701

Pre-operative systemic inflammatory response markers in predicting lymph node metastasis in endometrioid endometrial adenocarcinoma

To evaluate the correlation of pre-operative systemic inflammatory response (SIR) markers with lymph node (LN) metastasis compared with serum CA-125 in endometrioid endometrial adenocarcinoma. Retrospective review of 319 patients who were pathologically proven to have endometrioid endometrial adenocarcinoma after staging operations. Serum CA-125 and pre-operative SIR markers [neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), C-reactive protein (CRP), albumin, platelets and fibrinogen] were assessed. Receiver operating characteristic (ROC) curves were plotted for each SIR marker and serum CA-125. NLR, PLR and serum CA-125 were higher in the LN-positive group compared with the LN-negative group (p=0.003, 0.012 and 0.025, respectively). Serum albumin was significantly lower in the LN-positive group compared with the LN-negative group (p<0.001). ROC curves demonstrated the best cut-off values for NLR (≥1.97), PLR (≥9.14), albumin (≤4.15 g/dl) and serum CA-125 (≥32.50 U/ml) for pre-operative diagnosis of LN metastasis. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of serum CA-125 were 63.3%, 87.6%, 37.3%, 95.4% and 85.1%, respectively. No pre-operative SIR markers were superior to serum CA-125 in terms of sensitivity, specificity, PPV, NPV or accuracy, with the exception of the slightly higher sensitivity of PLR (64.5%). Pre-operative SIR markers do not appear to be more effective in predicting LN metastasis than serum CA-125 in endometrioid endometrial adenocarcinoma.

The value of serum CA125 for the development of virtual follow-up strategies for patients with epithelial ovarian cancer: a retrospective study

BackgroundSerum CA125 is routinely used in the follow up of ovarian cancer. The objective of the present study was to evaluate the usefulness of CA125 in the detection of ovarian cancer recurrence.MethodsThis retrospective case study was carried out at a tertiary gynaecological cancer centre in Australia. Patients with all cell types of epithelial ovarian cancer (EOC) treated between 2003 and2010 were considered eligible. We excluded patients whose aim of treatment was palliative, had no follow-up, had no pre-operative CA125 reading or had pre-operative CA125 levels < 35 U/mL. After primary treatment, patients were followed up as per guidelines suggested by National Comprehensive Cancer Network (NCCN). We recorded if symptoms, findings from physical examination, imaging or serum CA125 levels led to the diagnosis of recurrence. An increase in CA125 levels to twice the postoperative nadir was considered as "doubling" at any time during follow up.ResultsAnalysis is based on 56 patients who completed primary treatment and who presented for a total of 274 follow-up episodes. Of those, 29 patients (52%) developed a recurrence within the follow up period. Recurrence was diagnosed by CA125 alone in 14 of 29 patients (48%). CA125 was not elevated in 7 patients (24%) who recurred. Doubling of CA125 from nadir was observed in 27/29 patients. Of those 27 patients the doubling from nadir occurred within the normal range of 35 U/ml in 3 cases and outside the normal range in 24 cases. Multivariate analysis suggests that doubling of serum CA125 (OR 5.10, p 0.036) and nadir CA125 > 10 U/ml (OR 2.86, p 0.01) remained the only independent factors to predict ovarian cancer recurrence.ConclusionsThe present paper proposes the validation of a novel CA125 algorithm aiming to detect recurrent EOC. These data may allow us to investigate novel ways of follow up that do not require a patient's physical attendance at a clinic (virtual follow-up).

The Values of CA-125, Progesterone, ß-HCG and Estradiol in the Early Prediction of Ectopic Pregnancy

To explore the diagnostic value and measurement of serum CA-125, the single measurement of progesterone (P), ß-HCG, and estradiol (E2) in the early diagnosis of ectopic pregnancy. Serum levels of CA-125, progesterone, ß-HCG and estradiol were measured by Enzyme Linked Immuno Sorbent Assay (ELISA) techniques in 40 symptomatic women with ectopic pregnancy and 24 women with normal intrauterine pregnancy during gestational age of 4-10 weeks at Al-Kadhmiya Teaching Hospital, Baghdad, Iraq, between November 2010 and June 2011. The mean ±SEM serum levels of CA-125, progesterone, ß-HCG, and estradiol in patients with ectopic pregnancies (16.51±2.39U/ml; 2.54±0.47ng/ml; 72.75±12.27mIU/ml; 13.4±2.14pg/ml; respectively) were significantly lower than the levels in normal intrauterine pregnancies (74.25±18.5U/ml; 28.36±3.7ng/ml; 249.54±18.0mIU/ml; 112.7±23.6pg/ml; respectively). When using a CA-125 concentration of 20.5 U/ml as a cut-off value for the diagnosis of ectopic pregnancy, sensitivity was 75.7%, specificity 100%, the positive predictive value was 100% and the negative predictive value 71.4%. The measurement of CA-125 and progesterone levels is useful in discriminating ectopic from normal gestations.

Serum CA19-9 is a Significant Predictor among Preoperative Parameters for Early Recurrence after Resection of Pancreatic Adenocarcinoma

ObjectiveTo evaluate the preoperative factors predictive of postoperative early recurrence in patients with resected pancreatic cancer focusing on the serum CA19-9 value. MethodsOne hundred fifty-four patients undergoing surgical resection for pancreatic cancer were enrolled in this study. Univariate and multivariate analyses were performed to determine the predictors of early recurrence which was defined as relapse within 6 months after surgery. ResultsOn ROC curve analysis, the cutoff value of CA19-9 was determined to be 100 U/ml. Of 73 patients with CA19-9 value ≥ 100 U/ml, 39 (53 %) had early recurrence. In contrast, only 9 of 81 patients (11 %) with CA19-9 value < 100 U/ml developed a recurrence at an early period (p < 0.001). Multivariate analysis revealed that CA19-9 value ≥ 100 U/ml (odds ratio, 11.2) were significant predictors of early recurrence. The overall 3- and 5-year survival rates and median survival times were 47.3 %, 40.1 %, and 31 months in patients with CA19-9 value < 100 U/ml and 21.2 %, 9.4 %, and 16 months in patients with CA19-9 value ≥ 100 U/ml (p < 0.001). ConclusionsA preoperative CA19-9 value ≥ 100 U/ml was a significant predictor of early recurrence and a poor prognosis after resection for pancreatic adenocarcinoma.

Prognostic value of elevated preoperative serum CA125 in ovarian tumors of low malignant potential: A multinational collaborative study (ANZGOG0801)

ObjectivePrevious studies on prognostic factors in ovarian tumors of low malignant potential (LMP) were too small for robust conclusions. We examined the prognostic impact of preoperative serum CA125≥50U/ml levels in patients diagnosed with ovarian LMP tumors in a large multinational cohort. MethodsThis retrospective study included 940 patients with ovarian LMP tumors diagnosed between 1985 and 2008 at six gynecologic cancer centers. Patients either had radical treatment (bilateral salpingo-oophorectomy with or without hysterectomy) or conservative, fertility-sparing treatment. Multivariate Cox proportional hazard models were used to determine independent prognostic factors for disease-free (DFS) and overall survival (OS). Based on receiver operating characteristic curve (ROC), a preoperative serum CA125 level≥50U/ml was considered “elevated”. ResultsCA125 was more often elevated in serous than in mucinous tumors and in advanced FIGO stages (2 to 4) compared to stage1. DFS at 5years was 89% and 95% in patients with elevated and normal CA125 levels (p<0.05). Similarly, the 5-year OS was 90% among patients with elevated CA125 compared to 95% among patients with normal levels (p<0.05). For both DFS and OS elevated CA125 levels and advanced stages of the disease were independent prognostic factors. Analysis of subgroups revealed that CA125 was only prognostic in serous LMP tumors. ConclusionsIn the context of serous ovarian LMP tumors, elevated preoperative serum CA125 represents a biomarker independently associated with impaired disease-free and overall survival. CA125 is available in most centers and could inform surgeons about the risk of treatment failure.

Circulating Antinuclear Antibodies in Patients with Pelvic Masses Are Associated with Malignancy and Decreased Survival

BackgroundCirculating autoantibodies occur more frequently in cancer patients than in patients without cancer.Methods and FindingsWe examined sera from patients referred for pelvic mass symptoms to a tertiary university clinic. A total of 127 were diagnosed with epithelial ovarian cancer while 386 had a benign condition. A screen for IgG anti-nuclear antibodies (ANA) by indirect immunofluorescence on HEp-2 cells confirmed a highly significant overrepresentation of ANA in the cancer group where 40% had detectable (i.e., a titer ≥160) ANA compared with less than 12% in the benign group. The overrepresentation of ANA in the cancer group persisted (p<0.0001) after matching the age-profile of the benign group with the ovarian cancer group. Only 19 out of 127 patients in the age-matched benign subgroup were positive for ANA corresponding to an 85% specificity at 40% sensitivity of ANA as the only marker for malignancy. No correlation of ANA positivity in either group with specific bands in immunoblots could be demonstrated even though immunoblot positivity was clearly increased in the malignant group (41% vs. 3%). The presence, strength, and type of ANA did not correlate with serum CA-125 values or with staging, and ANA outcome did not contribute with independent diagnostic information. However, survival was significantly shorter in ANA-positive compared with ANA-negative cancer patients and patients with CA-125 below the median CA-125 value in the cancer group had a significantly decreased survival when positive for ANA. ANA status made no difference in the group with CA-125 values above the median. Also, there was a significant correlation between speckled ANA-strength and histological tumor grade.ConclusionsCirculating antibodies are a promising source for new biomarkers in cancer. Characterization of epitope specificities and measurements of consecutive samples will be important for further elucidating the role of ANA in evaluating ovarian cancer patients.

Clinical Significance of Serum COL6A3 in Pancreatic Ductal Adenocarcinoma

Introduction: Type VI collagen (COL6) forms a microfibrillar network associated with type I collagen fibrils and constitutes a major component of the prominent desmoplastic reaction in pancreatic ductal adenocarcinoma (PDA). We have demonstrated recently that a subunit of COL6, COL6A3, is expressed in high levels in PDA tissue and that the COL6A3 gene undergoes tumor-specific alternative splicing. the aim of this study is to investigate the diagnostic value and clinical significance of circulating COL6A3 in PDA. Methods: Serum samples were obtained from patients that underwent pancreatic resection at Thomas Jefferson University Hospital between 2006 and 2009. COL6A3 levels in the sera from patients with pathologically confirmed PDA (n=44), intraductal papillary mucinous neoplasms (IPMN) (n=22), cystadenomas (n=15), chronic pancreatitis (n=10) and neuroendocrine tumors (NET) (n=7) were analyzed by ELISA. Serum CA19-9 values were obtained from the electronic medical records. the prediction levels for malignancy were determined by the area under the receiver operating characteristic curve (AUC). Immunohistochemical staining for COL6A3 was performed on 12 tissue samples where both serum and paraffinized tissue samples from the same patients were available. Results: Circulating COL6A3 levels were significantly (p=0.0035) elevated in PDA patients when compared to all benign lesions. Compared to IPMN alone, COL6A3 levels were significantly higher in PDA (p=0.014). There were no significant differences between the levels in PDA and NET (p= 0.59). Interestingly, high COL6A3 serum levels correlated with lymph node invasion (p=0.006) and with tumor size (p=0.045). We assessed the level of association of log(col6a3) and log(ca19-9) with cancer status using a logistic regression model. With each increasing unit of log COL6A3, a patient is 12.9 times more likely to have cancer, with 95% CI (1.9, 86.8), p=0.009. the odds for each increasing unit of log CA19-9 are 2.4 times, with 95% CI (1.6, 3.7), p<0.001. the overall area under the receiver-operator curve (ROC) is 0.90. Immunohistochemical analysis revealed a strong COL6A3 staining in PDA and NET and its localization to the perineoplastic stroma and the malignant cells. Conclusions: Our data show for the first time the potential clinical significance of circulating COL6A3 levels in the diagnosis of pancreatic malignancy. Correlation of the high COL6A3 levels with tumor size and lymph node invasion suggests a role for COL6A3 in PDA progression and metastatic potential.

Ultrasonographic evaluation of simple ovarian cysts in postmenopausal women

The aim of our study was to evaluate the possibility of ultrasonography in differentiating malignant from nonmalignant cysts in postmenopausal women. The study included 100 postmenopausal women with diagnosis of simple ovarian cysts who were treated surgically at our clinic during the study period. In the group of operated patients the histopathological diagnosis confirmed benign cysts in most cases. In 1% of patients histopathological diagnosis was borderline or malignant tumor of the ovary. The risk of malignancy ranged from 0% in the cyst with a diameter below 50 mm, to 3.57% in cysts over 80 mm. Cyst diameter smaller than 50 mm and the volume of cyst less than 50 cm3 in correlation with the values of serum CA125 and clinical findings represent good algorithm for differentiating malignant from nonmalignant simple cyst.

Effect of different planes of nutrition on the some minerals concentration in the blood of goats

The effect of different levels of energy and protein on the blood concentration of calcium, phosphorus, copper and zinc were evaluated in four experiments. A total of nine growing castrated male balady kids having nearly the same age (8-9 months) and body weight (15-18kg) were experimented on. Four experiments, 3 trials per each were done on the same animals, with about 10 days as a rest period between one experiment and another, in which the animals were fed on control ration during the interval. The nine kids were randomly divided into 3 groups (A, B and C), 3 kids per each. The first group (A) was fed the control ration and used as control, while the other two groups (B and C) were fed the tested rations which furnished 15% more or less DE and CP than the control. The results indicated that feeding high protein ration slightly increased the mean value of serum P, Cu and Zn , while decreased the serum Ca level. Feeding high energy ration for growing kids was decreased the mean value of serum Ca, Cu and Zn and increased the mean value of serum P. On the other hand, feeding of HEHP ration was decreased the mean values of serum Ca and increased value of P. However, feeding low energy ration was increased serum Ca and Zn levels, while serum P and Cu were decreased. Feeding LEHP ration was decreased the mean values of serum Ca, P, Cu and Zn, while feeding LELP ration was decreased the mean value of serum P and Cu and increased serum Ca and Zn.

The utility of serum CA‐125 in predicting extra‐uterine disease in apparent early‐stage endometrial cancer

Surgical staging in early-stage uterine cancer is controversial. Preoperative serum CA-125 may be of clinical value in predicting the presence of extra-uterine disease in patients with apparent early-stage endometrial cancer. Between October 6, 2005, and June 17, 2010, 760 patients were enrolled in an international, multicentre, prospective randomized trial (LACE) comparing laparotomy with laparoscopy in the management of endometrial cancer apparently confined to the uterus. Of these, 657 patients with endometrial adenocarcinoma had a preoperative serum CA-125 value recorded. Multiple cross-validation analysis was undertaken to correlate preoperative serum CA-125 with stage of disease (Stage I vs. Stage II+) after surgery. Patients' median preoperative serum CA-125 was 14 U/ml. A cutoff point of 30 U/ml was associated with the smallest misclassification error, and using this cutoff, 98 patients (14.9%) had elevated CA-125 levels. Of those, 36 (36.7%) had evidence of extra-uterine disease. Of the 116 patients (17.7%) with evidence of extra-uterine disease, 31.0% had an elevated CA-125 level. On univariate and multivariable logistic regression analysis, only preoperative CA-125 level, but no other preoperative clinical characteristics were found to be associated with extra-uterine spread of disease. Utilizing a cutoff point of 30 U/ml achieved a sensitivity, specificity, positive predictive value and negative predictive value of 31.0, 88.5, 36.7 and 85.7%, respectively. Elevated CA-125 above 30 U/ml in patients with apparent early-stage disease is a risk factor for the presence of extra-uterine disease and may assist clinicians in the management of patients with clinical Stage I endometrial cancer.

Clinical value of serum CA 125, CA 19 - 9 and CA 72 - 4 combined determination in diagnosis of ovary tumor

Objective To explore the clinical value of serum CA125, CA19-9 and CA72-4 in ovary epithelial tumor and ovary endometriosis. Methods The detection results of ovary epithelial benign (n = 28) and malignant tumors (n = 15) and ovary endometriosis (n = 42) were retrospectively reviewed and compared with the results of 30 healthy women. Results The expression value of serum CA125 ,CA19-9 and CA72-4 in ovary epithelial cancers was obviously higher than others(all P ＜0.05). And the expression value of serum CA125 ,CA19-9 and CA72-4 in ovary endometriosis was higher than that of ovary benign tumors and the normal group (all P ＜ 0.05). Positive rate of combined determination was higher than that of single marker(P ＜0.05). Conclusion The detection of serum CA125,CA19-9 and CA72-4 had great significance in the diagnosis of ovary epithelial cancers. It could also be used in the diagnosis of ovary endometriosis. Key words: Ovarian neoplasms; Tumor markers,biological

Value of serum CA(125) detection for predicting recurrence and prognosis in ovarian epithelial cancer

To analyze the association of serum CA(125) level at the different phases with recurrence and survival, for providing simple and efficient methods about predicting recurrence and prognosis in epithelial ovarian cancer. The clinical-pathological data from 151 patients were collected, who were histologically confirmed as primary ovarian cancer between Jan 2002 and Dec 2005. All the patients were followed up. The relationship between serum CA(125) level at different phases and clinical-pathological data were analyzed, including prognostic associated factors, 2-year or 5-year recurrent rate, 5-year survival rate, progression-free survival times, and overall survival times. Serum CA(125) level at pre-surgery and the end of 3-course chemotherapy were associated with most of the clinical-pathological parameters, included stage, pathological grade, amount of ascites, residual tumor size, type of recurrence, 2-year and 5-year recurrent rate, and 5-year survival rate (all P < 0.05). Progression-free survival and overall survival times were shorter in the patients with higher CA(125) level at pre-surgery or abnormal CA(125) level at the end of 3-course chemotherapy (P < 0.01). There was no relationship between the ratio of CA(125) level at pre- and post-surgery and recurrence or prognosis (all P > 0.05). Serum CA(125) level at pre-surgery and the end of 3-course chemotherapy can be used for predicting the recurrence and prognosis of epithelial ovarian cancer.

CA 125 serum values in surgically treated endometriosis patients and its relationships with anatomic sites of endometriosis and pregnancy rate

Endometriosis is a benign gynecologic disease defined as the presence of functional endometrial glands and stroma outside the uterine cavity, causing dysmenorrhea, dyspareunia, menstrual irregularities, and infertility. Serum CA-125 measurement is now a consolidated method for diagnosing this condition, and its interpretation has posed a number of problems, particularly regarding utility in diagnosing minimal-mild endometriosis, whereas its value as a diagnostic aid in moderate-severe stages is well recognized. In our cohort, serum CA-125 values were significantly elevated in patients with ovarian and mixed endometriosis lesions (median levels 48 U/mL), compared with those who had exclusively extraovarian foci (median levels 27 U/mL), and so the correlation between this marker and the surgical and pathologic finding of ovarian and deep endometriosis was found to be statistically significant; however, the location did not affect the fertility rate.