CA125检测在卵巢上皮癌诊治监测中的价值探讨

１９９１年１月～１９９５年５月首次入院治疗的原发性卵巢上皮癌患者１５０例，复发性卵巢上皮癌患者２６例，卵巢癌第二次剖腹探查术１５例（共１９１例）。对ＣＡ１２５在卵巢上皮癌中的诊治监测价值进行探讨。结果发现１５０例首次治疗的卵巢上皮癌中，１３０例血ＣＡ１２５＞３５ｕ／ｍｌ，敏感性为８７％，特异性为８０％。其中浆液性上皮癌敏感性最高为９６％。Ｉ、Ⅱ期血ＣＡ１２５值为２１０±１０１ｕ／ｍｌ，Ⅲ、Ⅳ期为３９０±１５０ｕ／ｍｌ，Ｉ、Ⅱ期与Ⅲ、Ⅳ期ＣＡ１２５值之间有显著性等异（ｐ＜０．０５）；２６例复发卵巢癌中２２例血ＣＡ１２５值＞３５ｕ／ｍｌ，敏感性为８５％。１５例二探病人中，４例ＣＡ１２５值二探均为阳性。１１例血ＣＡ１２５值正常者中，６例二探结果为阳性，５例为阴性。提示ＣＡ１２５是目前辅助诊断卵巢上皮癌特别是浆液性腺癌最敏感的肿瘤指标；ＣＡ１２５的动态观察对卵巢上皮癌的治疗选择及预后判断具有重要价值。ＣＡ１２５的检测对二探的选择可提供可靠依据。     

血清CA125测定在妇科疾病中的应用价值

探讨血清ＣＡ１２５抗原测定对卵巢上皮癌等妇科疾病的临床应用价值。方法采用放射免疫法测定２０５例妇科疾病治疗前后血清ＣＡ１２５抗原含量。结果以ＣＡ１２５＞３５Ｕ／ｍｌ为阳性，其阳性率在卵巢上皮癌及子宫腺肌症或子宫内膜异位症分别为８４．６％（１１／１３）和６４％（１６／２５）。１１例血清ＣＡ１２５阳性的卵巢上皮癌患者经有效化疗和手术后，有９例＜３５Ｕ／ｍｌ以下。１６例ＣＡ１２５阳性的子宫腺肌症及子宫内膜异位症患者术后６周后均＜３５Ｕ／ｍｌ。当ＣＡ１２５复升高，预示上述疾病复发。结论血清ＣＡ１２５测定对卵巢上皮癌、子宫肌腺症和子宫内膜异位症的诊断、疗效评价和复发预测具有重要意义。     

血清ＣＡ１２５水平监测在卵巢癌肿瘤细胞减灭术中的应用价值

目的　探讨血清ＣＡ１２５水平监测在卵巢癌肿瘤细胞减灭术中的应用价值。方法　采用微粒子捕捉免疫发光技术（ＭＥＩＡ）测定７５例卵巢上皮癌患者治疗前、每１周期化疗结束后３周及手术前血清中ＣＡ１２５浓度。计算第１周期化疗后血清ＣＡ１２５下降率。分析术前血清ＣＡ１２５水平及新辅助化疗第１周期化疗后血清ＣＡ１２５下降率与肿瘤细胞减灭术成功率的关系;分析初始血清ＣＡ１２５水平与盆腔淋巴结转移的关系。结果　７５例卵巢上皮癌患者中ＣＡ１２５＞３５Ｕ／ｍｌ者７２例。５６例行新辅助化疗后患者第１周期化疗后血清ＣＡ１２５下降率≥５０％组与＜５０％组理想肿瘤细胞减灭术成功率无差异（Ｐ＝０.１８７）;新辅助化疗后患者术前血清ＣＡ１２５≤２００Ｕ／ｍｌ组与＞２００Ｕ／ｍｌ组理想肿瘤细胞减灭术成功率无差异（Ｐ＝０.０８４）;初诊时血清ＣＡ１２５＞８００Ｕ／ｍｌ组盆腔淋巴结阳性率高于≤８００Ｕ／ｍｌ组（Ｐ＝０.０２６）。结论　初诊时血清ＣＡ１２５＞８００Ｕ／ｍｌ组盆腔淋巴结阳性率高,可以作为选择淋巴结清扫术的参考指标。术前ＣＡ１２５水平及新辅助化疗后患者第１周期化疗后血清ＣＡ１２５下降率对选择卵巢癌肿瘤细胞减灭术的时机无指导意义。     

血清CA125水平监测上皮性卵巢癌临床复发的作用

目的：分析血清ＣＡ１２５对上皮性卵巢癌临床复发的监测作用。方法：应用放射免疫法测定血清ＣＡ１２５对经过治疗病情稳定,ＣＡ１２５降到正常的２８例上皮性卵巢患者,定期测定血清ＣＡ１２５水平及其他临床检查项目,直到临床诊断肿瘤复发,分析血清ＣＡ１２５水平与肿瘤复发的关系（以ＣＡ１２５〈３５Ｕ／ｍｌ为正常值）。结果：本组２８例患者中,血清ＣＡ１２５〉３５Ｕ／ｍｌ者１２例,阳性率为４２．９％;血清ＣＡ１２５     

胃肠道癌抗原（GCA）在消化道肿瘤诊断及判定预后中的意义

应用酶联免疫法测定５７例消化道肿瘤患者血清中胃肠道癌抗原（ＧＣＡ）浓度，以３７ｕ／ｍｌ为阳性界限值，测得消化道肿瘤ＧＣＡ阳性率５４．４％，其中胃癌５５．２％，肠癌５４．５％，食管癌２５％，肝癌６６．７％，而非消化道癌阳性率５．６％，正常人阳性率为５．０％。对９例消化道癌患者化疗前后ＧＣＡ变化的分析表明，ＧＣＡ水平的提高可预示病情的进展。提示ＧＣＡ可作为消化道肿瘤的辅助诊断指标及预后参考指标。     

消化道恶性肿瘤病人血清CA242水平及临床意义初探

作者采用生物素－链亲和素酶联免疫吸附试验方法，对１６４例消化道癌症病人血清ＣＡ２４２水平进行测定。结果，胰腺癌病人血清ＣＡ２４２含量最高（２８６．２±１２５．３Ｕ／ｍｌ），诊断阳性率为７６．９％，特异性为９１．２％；结直肠癌病人为１９３．６±１０６．４Ｕ／ｍｌ，诊断阳性率为６８．９％，特异性为８４．９％；与正常人及其它癌症病人比较，有非常显著性差异（Ｐ＜０．０１）。肝癌组为８６．１±３５．７Ｕ／ｍｌ，胃癌组为３７．６±１６．３Ｕ／ｍｌ，与正常对照组比较亦有显著性差异（Ｐ＜０．０５），但其敏感性仅分别为５８．３％和３２．３％。手术后病情明显缓解的病人，其血清ＣＡ２４２水平明显降低，与病情恶化或复发病人相比，有非常显著性差异（Ｐ＜０．０１）。其它癌症与良性疾病者血清ＣＡ２４２水平无显著性差异（Ｐ＞０．０５）。表明血清ＣＡ２４２水平测定对胰腺癌及结直肠癌的诊断、鉴别诊断、疗效观察和预后评估有一定价值。     

肺癌患者血清CA125研究

为探讨ＣＡ１２５在肺癌诊断，鉴别诊断，分期中的应用，采用免疫放射分析法测定了５０例肺癌患者血清ＣＡ１２５水平，结果显示：肺癌患者血清ＣＡ１２５水平显著增高，其增高的程度与肺癌ＴＮＭ分期直接相关，依次为ＩＶ期〉Ⅲ期〉Ⅱ期〉Ⅰ期，其中鳞癌，腺癌，小细胞未分化癌患者血清ＣＡ１２５水平差异无显著性，以１２Ｕ／ｍｌ为临界值，与正常对照组相比，血清ＣＡ１２５测定诊断肺癌的敏感度为６７．４％，特异度１００％；准     

肺癌患者血清CA125检测临床应用

目的：探讨ＣＡ１２５对肺癌鉴别诊断和观察疗效的临床意义。方法：采用免疫放射分析法测定健康人和按组织学分类和各类肺癌患血清ＣＡ１２５水平及阳性率,同时检测各样品的血清ＣＥＡ水平,进行统计分析。结果：患组较健康对照组ＣＡ１２５水平显增高（Ｐ〈０．０１）。肺鳞癌组ＣＡ１２５阳性率为８４％,腺癌为６５％,朱鳞癌为５６％,小细胞肺癌为４０％;１例大细胞肺癌ＣＡ１２５检测值为２３０Ｕ／ｍｌ、ＣＥＡ值１８     

肿瘤标志物CA15-3的免疫放射分析及其临床应用

目的发展一项新的肿瘤标志物免疫放射分析,并初步评价其临床应用价值。方法从瑞典引进单克隆抗体Ｍａ５５２与Ｍａ６９５,以前者为扑捉抗体,后者为标记抗体,建立一种夹心式的免疫放射分析。将Ｍａ５５２包被于聚苯乙烯小珠上,并以１２５－Ｉ标记Ｍａ６９５单抗。测定为室温下的一步反应。结果标准曲线的Ｂｍａｘ／Ｂ０为８２。本测定的灵敏度为０．３Ｕ／ｍｌ;批内与批间ＣＶ分别为８％与１０％。５０名正常女性血清ＣＡ１５－３值为１１．３±３．９Ｕ／ｍｌ,若以３０Ｕ／ｍｌ为判别的界值,则假阳性率为０％。良性乳腺病４０例,ＣＡ１５－３值９．６±５．８Ｕ／ｍｌ,假阳性率０％。６５例不同病程阶段的乳腺癌患者,疗前血清ＣＡ１５－３水平为８８．４±１５９．６Ｕ／ｍｌ,总阳性率５０．８％。肝转移,特别是骨转移引起显著的血清ＣＡ１５－３升高,阳性率可达１００％（ｎ＝９）。乳腺癌复发的患者ＣＡ１５－３阳性率为８０％（ｎ＝５）。结论新建成的免疫放射分析在乳腺癌的诊断,鉴别诊断,监视转移和复发中有高度的临床应用价值,比ＣＥＡ更好。     

盆腔、超声检查和CA125测定鉴别卵巢良恶性包块分析

目的：研究盆腔检查（ＰＥ）、超声检查（ＵＳ）及血清ＣＡ１２５水平在鉴别卵巢良恶性包块方面的作用及３项检查联合应用的价值。方法：对似手术治疗的卵巢包块患者在术前均行ＰＥ，ＵＳ及血清ＣＡ１２５测定。结果：绝经前妇女中８．５％（１１／１３０）为卵巢恶性肿瘤，绝经后妇女中３６．３％（２９／８０）为卵巢恶性肿瘤，ＰＥ的敏感性、特异性、阳性预测值、阴性预测值及准确性的百分率分别为６２．５％、８２．４％、４５．５％、９０．３％及７８．６％；ＣＡ１２５的上述诊断指数分别为８５．０％、８０．６％、５０．７％、９５．８％及８１．４％；ＵＳ的上述诊断指数分别为９５．０％、９４．１％、７９．２％、９８．８％及９４．３％。在３种检查方法中，ＵＳ的各项指数最好，尤其是在绝经后妇女。如果３项检查均为阴性，则所有患者的卵巢包块均为良性；如３项     

Coordinate elevation of serum markers in ovarian cancer but not in benign disease

Effective screening for occult ovarian cancer will require a strategy that is both sensitive and specific. Preliminary data suggest that CA 125 is elevated at diagnosis in a majority of patients with ovarian cancer. Although CA 125 is sufficiently specific to prompt its evaluation as one component of a strategy to detect ovarian cancer in postmenopausal women, a further improvement in specificity would facilitate cost-effective screening. In an attempt to develop a more specific screening strategy, multiple markers were assayed in a panel of sera from 47 patients with ovarian cancer and in a separate panel of sera from 50 individuals with benign disease whose serum CA 125 levels exceeded 35 U/ml. Among the patients with ovarian cancer, elevations of CA 125 (greater than 35 U/ml) were observed in 91%, CA 15-3 (greater than 30 U/ml) in 57%, TAG 72 (greater than 10 U/ml) in 49%, placental alkaline phosphatase (PLAP) in 25%, human milk fat globule protein (HMFG) 1 in 77%, HMFG2 in 62%, and NB/70K in 57%. Among the 50 sera selected from patients with benign disease, CA 125 was more than 35 U/ml in 100% and more than 65 U/ml in 42%. Among those patients with benign disease and elevated CA 125, NB/70K was elevated in 62%, HMFG1 in 26%, and HMFG2 in 12%, whereas TAG 72 and CA 15-3 were elevated in only 6% and 2%, respectively. In addition PLAP appeared promising; elevated enzyme levels were not found in the benign disease group. Among patients with ovarian cancer with CA 125 levels more than 35 U/ml, either TAG 72 or CA 15-3 was elevated in 77%. In the false-positive group, only 6% had elevations of one or the other marker. The CA 125 levels in cancer patients were, however, substantially greater than in patients with benign disease. If sera from patients with ovarian cancer were diluted to a range comparable to that found in benign disease, at least one of the two confirmatory tests was elevated in 63% of the samples from the malignant cases. Consequently, use of CA 15-3 and TAG 72 in combination with CA 125 can increase the apparent specificity of the CA 125 assay for distinguishing malignant from benign disease. Prospective studies will be required to test critically whether the use of additional serum markers in combination with the CA 125 assay would contribute to the specificity of a cost-effective screening strategy for ovarian cancer.     

Diagnosis and follow-up of ovarian cancer by a combination assay of serum sialyl SSEA-1 antigen and CA125 levels

We used a combination assay of serum sialyl SSEA-1 antigen (SLX) and CA125 levels, and evaluated the clinical usefulness of this technique for a diagnosis of ovarian cancer and follow-up of the patient with ovarian cancer. In 28 patients with ovarian tumors, the sera of 8 (66.7%) of 12 with ovarian cancer and 5 (71.4%) of the 7 with endometriosis (endometrial cyst) were positive for both SLX and CA125, but serum SLX level was 50 U/ml or less in all these 5 SLX-and-CA125 positive patients with endometriosis. The sera of all 9 patients with benign ovarian tumor were negative for both tumor markers. No patient with endometriosis was negative for both markers. The diagnostic accuracy (true positive rate X true negative rate) of the combination assay for ovarian cancer was 50.3% when the cut-off value of the serum SLX was 38 U/ml but improved to 81.8% when the value was set at 50 U/ml. From the above observations, a combination assay of serum SLX and CA125 is promising method for the differential diagnosis of malignant and benign ovarian tumors. Our results also suggest that to improve the diagnostic accuracy, the cut-off value of the serum SLX level should be 50 U/ml for ovarian tumors alone. We found following-up two cases of ovarian cancer that the serum SLX level is not affected by the ascites and inflammation. We expect that this combination assay of serum SLX and serum CA125 will be beneficial for diagnosis and follow-up of ovarian cancer.     

Measurement of the ovarian cancer-associated antigen CA 125 in monitoring tumor burden and response to chemotherapy

CA 125 serum levels were measured in 74 patients with ovarian carcinoma. Among 31 patients undergoing a second look laparotomy (SL) after chemotherapy pathologic complete response (PCR) was observed in 14 patients, residual disease (RD) less than 2 cm in 7 patients and RD greater than 2 cm in 10 patients. The disease status was compared to the CA 125 serum levels measured just before SL. Thirteen of the 14 patients with PCR had serum CA 125 values less than 35 U/ml (specificity: 93%). On the other hand, only 10 of the 17 patients with RD showed serum levels greater than 35 U/ml (sensitivity: 59%). Moreover, in the 43 patients receiving chemotherapy, CA 125 levels correlated with the course of the disease in 36 (84%). With regard to early detection of recurrence, in 9/14 patients with PCR, whose CA 125 levels were monitored monthly, by 1 to 7 months an increase of the tumor marker preceded clinical evidence of relapse in 9/9 relapses (100%). In conclusion, CA 125 assay can be helpful in the management of ovarian cancer patients, in monitoring the response to chemotherapy, in the early detection of tumor recurrence, and in predicting the SL findings, although the low sensitivity could be a major drawback in patients with RD before SL.     

CLINICAL DIAGNOSIS AND TREATMENT OF SMALL OVARIAN TUMOR IN POSTMENOPAUSAL WOMEN

Objective： To investigate the clinical symptom, ultrasonographic scan finding, serum CA125 value, histopathological type and treatment of small ovarian tumor （〈5 cm） in postmenopausal women. Methods： Retrospective analysis was carried out for 52 clinical materials of ovarian tumor cases in women more than one year after menopausal between Jan 1997 and Dec 2004. The largest diameter of the ovarian mass is less than 5 cm. Results： There were 11 ovarian cancers and 1 borderline ovarian tumor among 52 small ovarian tumors （23.1%）. 10 ovarian cancers were epithelial neoplasms and 2 were sex cord-stromal tumors, and 8 cases were in late stage according to FIGO staging system （33.3%）. Compared with benign tumor, there is no significant difference in the onset age, interval after menopausal and duration of history. The main clinical feature is abdominal symptoms, such as abdominal pain and distension in the malignant cases. The patients with benign tumors often showed the ovarian mass during the annual screening or admitted into hospital for other causes. The ultrasonography finding and serum CA125 level showed much difference between benign and malignant cases. Unilocular smooth-walled ovarian cysts mostly were found in benign tumor and the CA125 values were always less than 35 U/ml; but the solid or complex sonographic structures （multilocular, or with a papillary projections on the wall） often indicated a high risk of cancer, especially there was ascites in the pelvic cavity. Serum CA125 level in many cancer cases was elevated （〉35 U/ml）, over 300 U/ml in more than half of the patients. Surgery is still the first choice to treat ovarian cancer, and chemotherapy would be an auxiliary method. Till now, 3 ovarian cancer patients died of complications of cancer and 2 cases had recurrence. Conclusion： Small ovarian tumor in postmenopausal women has a comparatively low malignant occurrence but more in later stage. Many are epithelial carcinoma. If there is complex or parenchymal sonographic structure accompanied with a high serum CA125 level, operation should be considered, while it can be followed up when the ultrasound shows a smooth cyst with normal CA125 value.     

Monoclonal antibody immunoradiometric assay for an antigenic determinant (CA 125) associated with human epithelial ovarian carcinomas

CA 125 is an antigenic determinant expressed by greater than 80% of nonmucinous epithelial ovarian carcinomas. An immunoradiometric assay has been developed using a murine monoclonal antibody (OC125) to quantitate CA 125 in human serum. This immunoradiometric assay was optimized for specificity, sensitivity, and performance characteristics. Using a simultaneous immunoradiometric assay, the mean CA 125 concentration in 56 sera from healthy individuals was 11.2 +/- 5.4 (S.D.) units/ml, with 9.7 +/- 3.2 units/ml for 30 males and 13.1 +/- 6.8 units/ml for 26 females. A reference value of 35 units/ml included all 56 normals and excluded 86 of 105 (82%) ovarian carcinoma patients. This reference value also excluded 9 of 142 patients (6%) with benign diseases, but if the upper limit of normal was set at 65 units/ml, only 3 of 142 (2%) patients with benign diseases had elevated serum CA 125 levels, whereas 77 of 105 (73%) ovarian carcinoma patient sera remained positive. The ability of researchers, with this assay, to discriminate between CA 125 values in sera of patients with ovarian carcinoma and those of healthy individuals and patients with benign disease suggests that the assay deserves continued evaluation for monitoring and early diagnosis of ovarian cancer.     

Prospective multicenter study on the clinical utility of ca-72.4 in postmenopausal patients with pelvic mass

The study objective was to evaluate the sensitivity and specificity as well as the positive predictive value and negative predictive value of CA 72.4 and CA 125 determination, separately and in combination, for diagnosing ovarian tumors in post-menopausal women with pelvic mass. The 299 patients recruited in this study underwent gynecological examination, plasma determination of CA 72.4 and CA 125, and laparotomy with histological definition of pelvic mass. CA 72.4 assay values were under 3.9 U/ml in 194 cases (70.8%); values ranged from 3.9 to 4.5 U/ml in 7 cases (2.5%) and were greater than 4.5 U/ml in 73 cases (26.6%). CA 72.4 assay was positive (>4.5 U/ml) in 56 cases (57.1%) of malignant ovarian pathology, in 4 cases (25%) of malignant extra-ovarian pathology as well as in 9 cases (7.1%) of benign ovarian pathology and in 4 cases (11.8%) of benign extra-ovarian pathology. With a cut-off at 3.9 U/ml, CA 72.4 showed a specificity of 91.3% and a sensitivity of 62.2%, whereas with a cut-off at 4.5 U/ml specificity was 92.9% and sensitivity 57.1%. Results of CA 125 assay for diagnosing a pelvic neoplasia (ovarian or extra-ovarian), showed a specificity of 85.3% and sensitivity of 68.8%. The agreement of the two markers (CA 125 and CA 72.4) as negative or positive shows a specificity of 77% and a sensitivity of 84.7% for ovarian cancer and a specificity of 73.5% and sensitivity of 75% for the diagnosis of pelvic neoplasias.     

血清HE4及CA125水平检测在早期卵巢恶性肿瘤诊断中的价值

目的探讨血清人附睾蛋白4（HE4）及癌抗原125（CA125）水平检测在早期卵巢恶性肿瘤诊断中的价值。方法用酶联免疫吸附试验方法（ELISA）测定150例女性血清HE4、CA125水平,其中卵巢恶性肿瘤组（45例）、卵巢良性病变组55例及健康女性50例,分析两指标单独或联合检测诊断卵巢恶性肿瘤的价值。结果①卵巢恶性肿瘤组血清HE4和CA125水平（分别为344.66±256.37 pmol/L和516.07±609.07 U/ml）,分别与卵巢良性病变组（分别为53.77±19.03 pmol/L和41.17±62.08 U/ml）和正常组（分别为39.06±16.17 pmol/L和10.36±7.28 U/ml）比较,差异均有显著性（P〈0.001）;②根据ROC曲线,当HE4在80 pmol/L时诊断指数最大（0.806）,灵敏性和特异性分别为84.4%和92.4%,ROC曲线下面积0.948（95%CI 0.900～0.997,P=0.000）;③卵巢良性病变组血清HE4单项检测的假阳性率（5.5%）明显低于血清CA125单项检测的假阳性率（21.8%,P=0.012）;④HE4对早期卵巢癌的检测阳性率（73.3%）高于CA125检测的阳性率（33.3%,P=0.031）;⑤HE4单项检测对卵巢癌预测的特异度、阳性预测值（分别为94.6%和93.2%）高于CA125单项检测的特异度、阳性预测值（分别为78.2%和72.7%,P〈0.05）。联合CA125和HE4作为卵巢癌的诊断指标时,其诊断灵敏度为88.9%,高于单项血清CA125检测灵敏度（P〈0.05）。结论 HE4可作为卵巢癌诊断的独立生物学指标,其对早期卵巢癌的诊断价值优于CA125,两者联合检测可以提高CA125对卵巢癌的诊断能力。血清HE4水平以80 pmol/L为界值点对卵巢恶性肿瘤的诊断指数最大。     

Combined evaluation of serum CA 125 and CAM 29 in patients with epithelial ovarian cancer.

We examined 92 patients with epithelial ovarian cancer and 262 patients with benign ovarian diseases undergoing laparotomy. On the basis of a nonparametric method, antigen levels corresponding to prefixed 95% specificity values in a group of 674 women with benign gynecologic diseases were taken as cutoff limits (88.8 U/ml for CA 125 and 13.7 U/ml for CAM 29). Moreover, CA 125 and CAM 29 levels were measured serially during and after chemotherapy in 26 women selected from the patients with advanced epithelial ovarian cancer. At diagnosis, serum CA 125 was as sensitive as serum CAM 29 for nonmucinous tumors, but more sensitive than serum CAM 29 for mucinous tumors. The association of the two markers seemed to give no advantage over the CA 125 assay alone in the diagnosis of epithelial ovarian cancer. In monitoring the response to chemotherapy and follow-up of patients with epithelial ovarian cancer, changes in CA 125 levels correlated with the clinical course of disease better than changes in CAM 29 levels, and the serum CA 125 assay was more reliable than the serum CAM 29 assay in the early detection of tumor progression. In conclusion, serum CAM 29 did not seem to represent a complementary assay to serum CA 125 in the management of patients with epithelial ovarian cancer.     

Ca 125 Assay Used in Conjunction with Ca 15-3 and Tag-72 Assays for Discrimination Between Malignant and Non-Malignant Diseases of the Ovary

It has previously been suggested by the authors that elevated serum CA 125 levels may be of value in discriminating malignant from non-malignant pathologies among women with pelvic masses. Enhancement of this discrimination capacity might be achieved by utilizing additional serum assays. to test this hypothesis CA 125, CA 15-3 and TAG-72 levels were determined in double-blind fashion on 219 sera from patients undergoing diagnostic laparotomy for pelvic masses at six gynecological departments in the Stockholm area. Patient diagnoses were verified by chart review. of the 219 patients, 27 (12%) had non-mucinous ovarian carcinoma, of whom 26 (96%) had CA 125 levels of 35 U/ml or greater 23 (85%) had levels in excess of 65 U/ml. of 27 patients with mucinous or borderline ovarian carcinoma and patients with other malignancies 18 (67%) had CA 125 levels greater than 35 U/ml. of 165 women with non-malignant diagnoses 26 (16%) had CA 125 levels in excess of 35 U/ml and 8 (5%) greater than 65 U/mL Using reference values of 35 U/ml, 30 U/ml and 10 U/ml for the CA 125, CA 15-3 and TAG-72 assay respectively, only 3 of 165 (2%) of non-malignant patients were categorized as positive, compared to 23 of 27 (85%) of those with non-mucinous ovarian carcinoma. Moreover, an analysis of post-menopausal women revealed that the combination of assays—in a model controlling for the effect of CA 125—-increased the specificity for diagnosis of benign diseases in women with pelvic masses.