Biochemical markers in the plasma and tumors of patients with gynecologic malignancies

Abstract

Tumor markers in gynecologic malignancies can be classified generally as oncofetal proteins, carcino-placental proteins, and more specific tumor-associated antigens. Carcinoembryonic antigen (CEA) is most effective as a tumor marker in mucinous adenocarcinomas of the endocervix and ovary and in keratinizing squamous cell carcinomas of the cervix. In contrast, the use of alphafetoprotein (AFP) in gynecologic cancer is limited to patients with germ cell tumors of the ovary and specifically endodermal sinus tumors. The beta subunit of human chorionic gonadotropin (beta-hCG) remains an exemplary tumor marker for trophoblastic malignancies and may be useful in selected patients with epithelial carcinomas of the ovary. Plasma levels of these antigens are generally related to total tumor burden (tumor antigen concentration x extent of disease)). Although the lack of specificity of these markers has limited their use in the diagnosis of gynecologic malignancies, they have been effective as a means of monitoring disease status in patients whose tumors contain high antigen concentrations. More specific tumor-associated antigens have been described in ovarian cervical cancers, but their clinical efficacy remains to be demonstrated in large numbers of patients. Immunohistochemical staining of tissue specimens identifies patients whose tumors contain high antigen concentrations and who therefore should benefit most from serial plasma determinations following therapy. Potential future uses of biochemical markers include radioimmunodetection procedures using radiolabelled antibodies to tumor-associated antigens and antigen-directed chemotherapy.

A Review of the Role of Carcinoembryonic Antigen in Clinical Practice

“…Elevated CEA levels have been associated with a number of benign and malignant conditions (Table 5). CEA is used most frequently in CRC, but it is also a tumor marker in mucinous adenocarcinomas of the endocervix and ovary, as well as in keratinising squamous cell carcinomas of the cervix [41]. CEA levels >10 ng/mL or trending upwards are more commonly associated with malignant conditions [40][41][42][43].…”

“…CEA is used most frequently in CRC, but it is also a tumor marker in mucinous adenocarcinomas of the endocervix and ovary, as well as in keratinising squamous cell carcinomas of the cervix [41]. CEA levels >10 ng/mL or trending upwards are more commonly associated with malignant conditions [40][41][42][43]. Levels > 20 ng/mL are suspicious for metastatic disease [42,[44][45][46].…”

Post-treatment alterations of serum cancer antigen 125, cancer antigen 19.9 and carcinoembryonic antigen levels in patients with gynecological malignancies in a tertiary care hospital in eastern India

“…In this study, we have used a prospective non-randomized study design to observe the treatment effects on the changes of serum levels of three tumor markers (CA125, CA19.9 and CEA) in three common gynecological malignancies (ovarian, cervical, and endometrial). Previous studies point out the direct relation between the levels of the tumor markers and the gynecological tumor burden (tumor antigen concentration x extent of disease) 17 and hence, evaluating the alterations of the markers may help to infer about the effect of the treatment modalities in reducing the respective tumor burden.…”

Alpha‐fetoprotein in advanced epithelial ovarian cancer

“…AFP is a tumour marker which is positive in all cases of endodermal sinus tumour, a germ cell tumour of ovary (Van Nagell et al 1981). Moderate elevation of AFP was found in 43% of advanced epithelial ovarian cancer by Donaldson et al (1980).…”