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Introduction: Globally, ovarian carcinoma is the 7th most common cancer. Cancer antigen 125 (CA-125) is the most frequently used biomarker for ovarian cancer (OC). Carcinoembryonic antigen (CEA) is present only at very low levels in healthy adults and is raised in colon cancer, pancreatic malignancies, pancreatitis, cirrhosis, etc. The present study is to evaluate the ability of CEA in combination with CA-125 to differentiate epithelial ovarian malignancies from non-ovarian malignancies. Aims and objectives: To study, compare, and calculate the ratio of serum CA-125 and serum CEA levels in cases of epithelial ovarian malignancies and non-ovarian malignancies. Materials and methods: Thirty patients of epithelial ovarian malignancies in group I and 30 female patients of non-ovarian malignancies in group II are included. Results: Specificity and positive predictive value (PPV) increase when CA-125 to CEA ratio increases and both are 100% if the ratio is >50. When CEA (<5 ng/mL) alone is used for distinguishing an ovarian malignancy from a non-ovarian malignancy, sensitivity is only 93%, specificity 67%, PPV 74%, negative predictive value (NPV) 91%, respectively. Conclusion: When CA-125/CEA ratio increases, the sensitivity and NPV fall but the specificity and PPV increase and became 100% when it is >50. By knowing the ratio we can have an early diagnosis of OC. We cannot always consider the cut-off for CEA as <5 ng/mL because in smokers the reference value is up to 10 ng/mL.

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