A Prospective Study of Tumor Markers CA 125 and CA 19.9 in Patients with Epithelial Ovarian Carcinomas

Abstract

In a prospective study, CA 125 and CA 19.9 serum levels were measured in 229 patients with ovarian cancer [121 with active disease, 108 in complete remission (CR)], and in 20 patients with other malignancies. Abnormal levels of CA 125 were found in 90% of patients with active ovarian cancer, in 1.8% of those in CR and in 38% of cases with other malignancies. Abnormal CA 19.9 serum levels were found in 36, 9 and 48 % of these groups, respectively. Serum levels of both tumor markers were related to tumor stage and histological type. The highest levels of CA 125 were found in serous adenocarcinoma and the lowest in the mucinous type (p < 0.0001). In contrast, significantly higher CA 19.9 values were found in mucinous carcinoma than in other histologies (p < 0.0001). CA 125 and CA 19.9 were useful for monitoring disease activity in 88.3 and 32%, respectively, while one or other tumor marker was useful in 92% of patients. At the time of the second-look operation, abnormal CA 125 serum levels were found in 32% (6/19) of patients with active disease and in none of those with CR (0/38). CA 125 sensitivity was 83% (5/6) in those patients with residual tumor > 2 cm and in 8% (1/13) in those with tumor < 2 cm. CA 19.9 values were abnormally high in 16% of cases with persistent disease and in 11 % of CR patients. In conclusion, our results confirm that CA 125 is a useful marker in ovarian carcinoma. CA 19.9 improves the results obtained with CA 125 alone only in mucinous adenocarcinomas.

Tissue CA125 and HE4 Gene Expression Levels Offer Superior Accuracy in Discriminating Benign from Malignant Pelvic Masses

“…Nevertheless, elevated serum CA125 levels are only seen in 50% of patients presented with early stage ovarian cancer and 80%-90% of patients with late stage disease, thus limiting its sensitivity (Molina et al, 1992;Rosen et al, 2005). Furthermore, the utility of CA125 as a biomarker for detecting ovarian cancer is hindered by the documented lack of specificity, since elevated serum CA125 concentrations can be found not only in a broad range of benign gynecologic diseases, but also in malignancies of different origin, including non-ovarian gynecologic cancers, other epithelial tumors and nonepithelial malignancies (Buamah, 2000;Miralles et al, 2003;Somigliana et al, 2004;Molina et al, 2008;Park et al, 2011).…”

Alternative antibody for the detection of CA19-9 antigen: a European multicenter study for the evaluation of the analytical and clinical performance of the Access® GI Monitor assay on the UniCel® DxI 800 Immunoassay System

“…Koprowski et al defined CA19-9 using the monoclonal antibody 1116-NS-19-9, which was produced by a mouse spleen hybridoma immunized with a human colorectal carcinoma cell line (11,13). CA19-9 is detected in colorectal, gastric and pancreatic cancer tissues (80%-90%), but also in liver, gall bladder, lung, breast and gynecological cancers (8,9,(14)(15)(16). In serum, only low concentrations of the high molecular, mucinous CA19-9 (molecular weight 900,000 Da) are found physiologically.…”

Comparison of Serum Human Epididymis Protein 4 with Cancer Antigen 125 as a Tumor Marker in Patients with Malignant and Nonmalignant Diseases

“…Cancer antigen 125 (CA-125) 3 is the tumor marker of choice in ovarian cancer (2, 4 -6 ). A diagnostic approach based on the use of CA 125 in association with echocardiographic techniques has been suggested for the early diagnosis of ovarian cancer (2,(3)(4)(5)(6)(7). However, this approach has several drawbacks, including low sensitivity and specificity.…”

“…However, this approach has several drawbacks, including low sensitivity and specificity. The diagnostic sensitivity of CA 125 in ovarian cancer is related to tumor stage, with abnormal CA 125 serum concentrations seen in approximately 50% of patients with stage I disease and 80%-90% of patients with stages III-IV disease (3)(4)(5)(6)(7)(8)(9). However, the most important problem with CA 125 is its low diagnostic specificity, with abnormally high concentrations found in malignancies of different origin, including nonovarian gynecologic cancers (endometrium, endocervix), other epithelial tumors (lung cancer), and nonepithelial malignancies such as lymphomas (4,(7)(8)(9)(10)(11)(12)(13)(14)(15)(16).…”