Application of tumor markers in ovarian malignancies

Abstract

Ovarian cancer is the fifth leading cause of death in women. The incidence of this malignancy increases in women over the age of 40. The overall five years survival is less than 30%, as most women present with advanced stage disease. Until recently, detection of early stage ovarian cancer has been difficult since it is usually nonpalpable and asymptomatic. The definitive diagnosis of an ovarian mass is a common problem in gynecologic patients with adnexal mass. The routine standard evaluation for adnexal masses includes patient's history, physical examination, ultrasound and histopathological examination. These parameters individually or in combination have little predictive value. The accuracy of diagnostic tools are of immense value and great concern to practicsing Gynecologists and Oncologists. The clinical application of serum concentration of CA 125, AFP and hCG is of great help not only as diagnostic aid but also in monitoring efficacy of any treatment modality like chemotherapy, radiotherapy or surgical resection. Additionally, evaluation of tumor marker concentration helps in predicting early biochemical recurrence and in prognostication in different types of ovarian malignancies. The ability to differentiate a malignant mass from a benign pelvic mass pretherapeutically could be enhanced optimally by additional use of tumor markers such as cancer antigen CA-125, alphafetoprotein and human chorionic gonadotrophin in pre-and postmenopausal women.

Study of Various Gross And Histological Patterns of Ovarian Tumors

“…Myxoid areas in the gross were seen as cartilage microscopically and yellow areas were observed as adipose tissue, both were components of mesoderm. Incidence of the present study is 15% and comparable with theabove studies of Bhattacharya MM et al and Ganga S. Pilli et al [5,6] …”

“…Out of 74 benign lesions, 69 lesions are unilateral (93.24%) and remaining 5 lesions are bilateral (6.75%). In 6 cases of malignant lesions 5 are unilateral lesions (83.33%) and bilateral are 1 lesion (16.67%) Ganga S. Pilli et al reported 92.2% of the benign lesions are unilateral and 74.2% of the malignant lesions are unilateral [6] which are correlated with the present study.…”

“…Peak incidence is between 30 to 50 yrs age group, covering 67% of the lesions. Ganga S. Pilli et al (2002) [6] reported the peak incidence of ovarian tumors in the 3rd and 4th decades accounting 55.7%. Bhattacharya MM et al (1980) reported that the 2/3rd of the benign tumors were seen between 20 to 40 yrs and 2/3rd of the malignant tumors were seen after the age of 40 yrs.…”

“…[5,6]. In the present study, neoplastic lesions are recorded in the range of 13 to 66 years agegroup.…”

A giant ovarian mucinous tumor in a 58-year-old postmenopausal patient with persistent abdominal pain and high serum levels of CA 19-9

“…Women with abdominal-pelvic masses constitute a challenging condition in general practice because the clinical features and findings from physical examination are usually nonspecific. The clinical application of tumor markers, such as serum concentration of CA 125, AFP and hCG is of great help not only as diagnostic aid but also in monitoring efficacy of any treatment modality like chemotherapy, radiotherapy or surgical resection [ 4 , 7 ]. Carbohydrate antigen 19-9 (CA 19-9) (a sialylated lewis glycoprotein antigen), a commonly used marker of benign and malignant hepatobiliary and pancreatic conditions, has also been found to be raised in some ovarian neoplasms [ 8 ].…”