Significance of CA 125 serum level in discrimination between benign and malignant masses in the pelvis

Aim Our aim was to confirm that preoperative CA 125 serum level can be useful for discrimination between benign and malignant masses in the pelvis.Methods Preoperative CA 125 serum level was analyzed retrospectively in 121 patients who had surgery because of a malignant ovarian tumor and in 91 patients with benign masses in the pelvis. The cutoff serum level CA 125 between benign and malignant masses in the pelvis was 35 and 65 IU/ml.Results Of those patients with a malignant ovarian tumor, 65.3% had menopause whereas only 31.5% of those with a benign tumor did so. The average age of the patients with a malignant tumor was 54.2 years and of those with a benign tumor 46.8 years. The preoperative CA 125 serum level was higher than 35 IU/ml in 80.2% and higher than 65 IU/ml in 72.7% of all analyzed patients with a malignant tumor, whereas it was 23.9% and 9.8% respectively in patients with a benign mass. In early stage ovarian cancer disease (borderline stage, I/II) the preoperative CA 125 serum level was higher than 35 IU/ml in 67.8% and in 52.5% higher than 65 IU/ml. In advanced stages (III/IV), it was higher than 35 and 65 IU/ml in 96.1%. After therapy the CA 125 serum level dropped below 35 IU/ml in 70.8% and after three chemotherapy courses in 78.1%. A CA 125 level less than 35 IU/ml was achieved by therapy in 84.2% patients with an early stage disease (I/II) and in 62.1% in advanced stages (III/IV). The calculated sensitivity was 80.2% and negative 74.5% (CA 125 higher than 35 IU/ml) and 72.7%, 90.2%, 90.7%, 71.6% respectively (CA 125 higher than 65 IU/ml).Conclusion Preoperative determination of CA 125 is a very useful method to discriminate between benign and malignant masses in the pelvis.     

A retrospective study of preoperative CA 125 levels in 82 patients with ovarian cancer

Introduction. The aim of our study was to investigate preoperative serum CA 125 as a prognostic factor in patients with ovarian carcinoma.Methods. A retrospective analysis was conducted on 82 patients with ovarian carcinoma treated at our Unit between 1998 and 2000 who had a serum CA 125, evaluated by a commercially available radioimmunoassay, prior to cytoreductive surgery. We looked for an association between preoperative CA 125 and known prognostic factors of ovarian cancer. We compared outcomes of patients with preoperative CA 125 at or below to 500 U/ml with outcomes of patients with preoperative CA 125 above 500 U/ml.Results. A significant (p<0.002) correlation between stage and CA 125 serum levels was found as 16 out of 18 stage I–II patients (89%) had CA 125 level 500 U/ml and 36 out of 64 stage III–IV patients (56%) had CA 125 level >500 U/ml. Among stage III and IV patients there was nonstatistically significant relation between serum CA 125 and histologic grade (G1+G2 vs. G3) and residual disease (<1 cm vs. >1 cm) after primary cytoreductive surgery. Preoperative serum CA-125 level did not predict either recurrences or disease free interval.Conclusion. Preoperative CA 125 correlated well with FIGO stage but not with age, grade, residual disease after primary surgery, relapse and disease free interval.     

血清CA125结合B超对绝经后妇女卵巢恶性病变的预测价值

目的 通过了解绝经后妇女卵巢肿物的临床特点，探讨早期发现绝经后妇女卵巢恶性肿瘤的可行方法。方法 回顾分析302例经手术后病理证实为卵巢肿物的自然绝经后妇女的临床特点，采用B超结合血CA125的定量测定。结果 71．2％的绝经后卵巢肿物患者无自觉症状，38．7％为卵巢恶性肿瘤，BUS结合血CA125对卵巢恶性病变预测的敏感性为98．4％，特异性为57．9％，阳性预测值62．6％，阴性预测值98．1％。结论 对绝经后妇女实施妇科检查及B超的筛查结合血CA125的定量测定，有助于临床医生及时发现卵巢恶性肿瘤。     

A study of serum CASA and CA 125 levels in patients with ovarian carcinoma

The assays of Cancer Associated Serum Antigen (CASA) and CA 125 were assessed in the management of patients with ovarian cancer. It was shown that CASA is sensitive to ovarian carcinoma, and both CASA and CA 125 are more useful when used in conjunction.     

Serum CA 125 levels and survival in advanced ovarian cancer

We made a retrospective analysis of 85 patients with elevated serum CA 125 after surgery for ovarian cancer. Absolute CA 125 serum levels were a poor guide to prognosis. However, the ratio between the serum CA 125 after the first, second, or third course of treatment and the postoperative value was an excellent guide to prognosis. These were also independent and stable in the Cox Regression analysis.     

Evaluation of serum CA 125 level as a tumor marker in borderline tumors of the ovary

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.     

血清CA125预测卵巢上皮癌治疗后复发的Meta分析

目的:系统评价血清CA125对卵巢上皮癌综合治疗(手术+化疗)后复发的诊断价值。方法:计算机检索Pub Med、EMBASE、Cochrane Library、Web of Science、中国生物医学文献数据库(CBM)、中国期刊全文数据库(CJFD)、中国科技期刊数据库(CSJD)、中国知网(CNKI)数据库,检验医学专业数据库:IFCC循证实验医学数据库、Medion、CRDdatabase、Bandlier Knowledge library等;灰色文献检索:中国学术会议论文库(CACP)、ISTP,检索期限自建库至2015年12月31日。收集有关血清CA125诊断卵巢上皮癌综合治疗后复发的前瞻性或回顾性队列研究。使用诊断性试验准确性质量评价工具(QUADAS)评价文献质量并提取数据,采用Meta-Disc1.4版软件进行Meta分析。结果:共纳入33篇文献,共2188例患者。Meta分析结果显示,血清CA125对卵巢上皮癌治疗后复发的诊断优势比DOR为11.77(95%Cl为7.16~19.37),灵敏度为67%(95%Cl为65%~70%),特异度为83%(95%Cl为80%~85%),阳性似然比为3.83(95%Cl为2.70~5.43),阴性似然比为0.41(95%Cl为0.35~0.49)。结论:血清CA125阴性排除"卵巢癌复发"的价值较大,而阳性诊断"卵巢癌复发"的价值有待进一步确证。     

晚期卵巢透明细胞癌术前CA125水平和瘤体减灭满意度关系的回顾性分析

目的:探讨晚期卵巢透明细胞癌术前血清CA125水平与瘤体减灭术满意与否的相关性。方法:回顾分析21例晚期卵巢透明细胞癌患者的临床和病理特点,并采用四格表确切概率计算法分析术前血清CA125水平与瘤体减灭术满意度的关系。结果:术前血清CA125>35IU/ml者16例(76.1%)。根据术前血清CA125水平是否≥500IU/ml将21例患者分为两组:CA125≥500IU/ml者9例(42.86%),其中瘤体减灭术满意1例,不满意8例;CA125<500IU/ml者12例(57.14%),其中瘤体减灭术满意6例,不满意6例。CA125≥500IU/ml组的瘤体减灭术满意率明显高于CA125<500IU/ml组,但无统计学差异(P=0.078)。结论:利用术前CA125血清学水平预测瘤体减灭术的满意度有一定的局限性。     

CA_(125)、CA_(724)、CA_(199)、BFP检测对判定卵巢浆液性囊腺癌疗效的意义

目的:探讨检测CA_(125)、CA_(724)、CA_(199)及BFP对卵巢浆液性囊腺癌患者诊断及疗效监测的意义。方法:用RIA或EIA测定卵巢浆液性囊腺癌患者术前及术后24个月内血CA_(125)、CA_(724)、CA_(199)及BFP,以腹腔镜检查及剖腹探查术为对照,监测上述4项标记物。结果:(1)术前各项标记物的阳性率为57.1%～79.1%,以CA_(125)最高;3项标记物组合阳性率为79.1%～85.7%。(2)Ⅰ期患者组合阳性率达80%,而且3项组合测定(CA_(125)+CA_(724)+BFP)即可达此水平。(3)3例复发病例均有2项以上标记物超过界值,即3项标记物组合阳性率可达100%。(4)每项单独测定均有假阴性。(5)CA_(125)单独测定有1例假阳性。结论:标记物的组合测定可覆盖复发病例,也能有效地提示绝大部分早期病例,但应注意单独检测有假阴性和假阳性的问题。     

The role of preoperative serum cancer antigen 125 in malignant ovarian germ cell tumors

Objective

To determine the role of preoperative serum cancer antigen 125 (CA 125) in malignant ovarian germ cell tumors (MOGCTs).

术前血清CRP测定对评估卵巢上皮癌预后的价值

目的:探讨血清C反应蛋白(C-reactive protein,CRP)与上皮性卵巢癌(epithelial ovarian cancer,EOC)临床病理参数、CA125的相关性及评估EOC预后的价值。方法:测定61例EOC患者术前血清CRP及CA125,分析CRP与临床病理参数及CA125的相关性。结果:术前EOC患者血清CRP的中位数为13.06mg/L,CRP阳性者38例(38/61),明显高于对照组(P<0.001)。术前血清CRP水平与EOC的FIGO分期、淋巴结转移、腹水形成关系密切。FIGOⅢ~Ⅳ期、淋巴结转移阳性、腹水形成者CRP中位数显著增高。多因素Logistic回归分析也提示肿瘤FIGO分期、腹水形成和淋巴结转移与CRP阳性表达相关(P<0.05)。研究还表明,CRP水平与手术方式满意度及残余灶大小关系非常密切,CRP值越高,预示手术满意度越差、残余灶越大;血清CRP、CA125的秩和相关分析显示CRP与CA125之间存在正相关(P=0.000)。结论:术前血清CRP可作为判断EOC预后的有价值指标。     

Ovarian tumors of low malignant potential: a retrospective study of 234 patients

Two-hundred and thirty-four consecutive patients with a histologic diagnosis of low malignant potential (LMP) ovarian tumors between 1972 and 1994 form the basis of this study. Six patients had a synchronous intra-abdominal or pelvic malignancy and six were considered to have areas of early stromal invasion, these patients being considered separately. The patients ages ranged from 16–93 years. The histologic type was mucinous in 53%, serous in 37%, mixed in 7%, and other in 3%. Ovarian tumors were bilateral in 15% with mucinous and 39% with serous disease. Fourteen patients had pseudomyxoma peritonei. Extra ovarian disease was found in 28 (34%) patients with serous and 15 (13%) with mucinous tumors. Five (6%) patients with serous tumors had invasive implants and four had lymph node implants. Clinically 175 patients had stage I disease, 19 had stage II and 28 stage III disease but only 88 patients were formally staged. Follow-up details were available for 173 (74%) patients, ranging from 2 months to 20 years, mean 54 months. Thirteen patients (6%) died of disease, of whom six had pseudomyxoma peritonei. Twelve patients (6%) had developed invasive malignancy of whom seven died. None of the patients with formally staged Ia or Ib disease had a recurrence. With the exception of patients with synchronous malignancy or pseudomyxoma peritonei the prognosis is good. Surgical staging offers limited prognostic information but sacrifice of fertility is not justified. Adjuvant therapy is not indicated in early stage disease and its role for patients with extra ovarian disease remains controversial.     

A CA125 score as a prognostic index in patients with ovarian cancer

Summary Due to its high specificity (90%) and sensitivity (86%) measurement of CA125 has become well-established in patients with epithelial ovarian cancer. We have formulated a CA125 prognostic score and examined its validity as an additional prognosis index. This score is composed of two CA125 values (one determined preoperatively and one 1 month after operation). CA125 serum levels of 0–64 IU/ml received 1 point, levels of 65–299 IU/ml were given 2 points, and those >300 IU/ml were given 3 points. These points are added to produce the CA125 prognostic score. Statistical comparison demonstrated that patients with scores of 2 or 3 had a significantly (P=0.0005) better prognosis than patients with scores of 4, 5 or 6. The classical prognostics features such as the FIGO stage, residual tumor mass and ascites were found to correlate with the CA125 prognostic score.     

Accuracy of CA 125 in the diagnosis of ovarian tumors: a quantitative systematic review

A quantitative systematic review was performed to estimate the accuracy of CA 125 assay in the diagnosis of ovarian tumors. Studies that evaluated CA 125 levels for the diagnosis of ovarian tumors and compared them with paraffin-embedded sections as the diagnostic standard were included. Seventeen studies were analyzed, which included 2374 women. The pooled sensitivity for the diagnosis of borderline tumors or ovarian cancer was 0.80 (I.C. 95% 0.76-0.82) and the specificity was 0.75 (I.C. 95% 0.73-0.77). The diagnostic odds ratio for ovarian cancer and borderline lesions vs. benign lesions was 21.2 (95% C.I., 12-37). Summary receiver operating characteristic curves were constructed due to heterogeneity in the diagnostic odds ratio. For malignant and borderline ovarian tumors vs. benign lesions the area under the curve was 0.8877. A CA 125 level of >or= 35 U/ml is a useful preoperative test for predicting the benign or malignant nature of pelvic masses. The accuracy of CA 125 in the diagnosis of ovarian tumors is high and very important in helping the surgeon to decide what kind of surgery should be performed.     

卵巢良性肿块伴腹水和血清CA125升高的临床分析--附三例报告

目的 探讨卵巢良性肿瘤伴腹水和血清CA125升高的临床特征。方法 对我院收治的3例患者进行临床分析并复习相关文献。结果 3例患者术前均误诊为卵巢癌而手术治疗,并均于手术中确诊;术前均无恶性肿瘤的诊断证据,如病理学和(或)细胞学阳性发现,也无特征性的超声表现。该类疾病以盆腔结核性肿块、卵巢子宫内膜异位囊肿和卵巢纤维瘤最常见,其他的有卵巢泡膜纤维瘤、腺纤维瘤、卵巢甲状腺肿、卵巢泡膜细胞瘤、卵巢良性Brenner瘤、卵巢成熟畸胎瘤、卵巢水肿和卵巢纤维瘤样变。结论 盆腔肿块伴腹水和血清CA125升高,并不能立即诊断卵巢癌。病理学和细胞学检查是惟一确诊的方法;对可疑病例腹腔镜检查是简便、可靠的方法。     

Surgical staging for epithelial ovarian tumors of low malignant potential

From January 1975 to December 1991, 34 patients with a diagnosis of epithelial ovarian tumors of low malignant potential (LMP) were admitted to the Istituto Nazionale Tumori of Milan. Eighteen of them (group 1) underwent complete staging laparotomy and retroperitoneal para-aortic and pelvic lymphadenectomy, as for ovarian cancer. In the remaining 16 cases (group 2), the surgical treatment ranged from unilateral oophorectomy to incomplete staging procedure. In group 1, nine patients (50%) were found to have retroperitoneal nodal involvement. In group 2, all patients had stage I disease. Patients were followed up for 20–222 months (mean 108, median 86). There were two recurrences in group 2 (after 5 years) and none in group 1 (NS). Currently all patients are alive and disease free. Nine of 18 group 1 patients were upstaged to stage III on the basis of lymph node involvement only. However, at least in this retrospective series, lymph node metastases did not affect prognosis or survival.     

IOTA SR 与 CA125、HE4、ROMA、RMI1、GI-RADS对卵巢良恶性肿瘤的诊断价值比较

目的 探讨糖链多肽抗原125(CA125)、人附睾蛋白4(HE4)、恶性肿瘤风险算法(ROMA)、恶性风险指数1(RMI1)、国际卵巢肿瘤分析简单规则(IOTA SR)、妇科影像报告与数据系统(GI-RADS)在卵巢良恶性肿瘤鉴别诊断中的价值.方法 选取2019年7 月至2020年7 月于锦州医科大学附属第一医院83例...     

晚期卵巢上皮性癌患者初次治疗过程中血清CA125水平变化与其预后的关系

目的 探讨晚期(Ⅲ～Ⅳ期)卵巢上皮性癌(卵巢癌)患者初次治疗过程中血清CA125水平变化与其预后的关系.方法 选择1998年1月-2003年12月间中山大学肿瘤防治中心妇瘤科收治的142例晚期卵巢癌患者,回顾性分析其初次治疗过程中血清CA125水平的变化,采用Kaplan-Meier法计算其累积生存率,并采用Cox风险比例回归模型分析血清CA125水平的变化对患者预后的影响.结果 根据患者治疗前血清CA125水平不同分为≤500、>500～1500和>1500 kU/L,其3年累积生存率(分别为64%、71%及64%)比较,差异无统计学意义(P>0.05).术后接受3个疗程化疗后,血清CA125水平降至正常(0～35 kU/L)的77例患者的3年及5年累积生存率分别为84%及56%,明显高于血清CA125水平仍为异常的48例患者(分别为42%、15%,P<0.01).多因素分析表明,残留灶直径(P<0.01)及3个疗程化疗后血清CA125水平(P<0.01)是影响晚期卵巢癌患者预后的独立的因素.进一步分层分析表明,接受了满意的肿瘤细胞减灭术(残留灶直径≤1 cm)的患者中,3个疗程化疗后血清CA125水平降至正常者的3年及5年累积生存率分别为88%、64%,明显高于化疗后血清CA125笛水平仍为异常者(分别为52%、18%,P<0.01);同样,接受了不满意的肿瘤细胞减灭术(残留灶直径>1 cm)的患者中,3个疗程化疗后血清CA125水平降至正常者的3年和5年累积生存率分别为74%、32%,明显高于化疗后血清CA125水平仍为异常者的33%、13%(P<0.01).结论 3个疗程化疗后血清CA125水平正常与否可预测晚期卵巢癌患者的预后,且无论初次手术是否为满意的肿瘤细胞减灭术,3个疗程化疗后血清CA125水平降至正常者较未降至正常者预后好.     

Imperforate hymen: a new benign reason for highly elevated serum CA 19.9 and CA 125 levels

Absract Imperforate hymen is a urogenital tract anomaly that represents the most frequent congenital malformation of the female genital tract. CA 19-9 and CA 125 are widely used as tumor markers, however several benign conditions are also known to increase serum CA 19-9 and CA 125 levels. According to classical textbook knowledge, imperforate hymen is not listed under the benign conditions that increase serum CA 19-9 and CA 125 levels. In this case report we describe a relation between imperforate hymen and elevated serum CA 19-9 and CA 125 levels.