Gynecologic tumor markers

Abstract

The advent of monoclonal technology has increased the potential utility of antibody-dependent tumor marker assays in gynecologic oncology. The availability of unlimited quantities of several pure monoclonal antibodies directed against novel epitopes on tumor-associated antigens has permitted development of highly sensitive assays for serum markers. Traditional assays for human chorionic gonadotropin (hCG), NB/70K and TA-4 have been improved. CA 125 has provided a useful first-generation marker for monitoring ovarian cancer and triaging patients with pelvic masses, despite limitations in sensitivity and specificity. In the next decade, the challenge is to identify new markers that will complement CA 125 in monitoring ovarian cancer and facilitate screening for occult early-stage disease. Strategies involving multiple markers and modalities may be required. Some markers may emerge through a more fundamental knowledge of the biology of gynecologic neoplasms, including the expression of growth factors and their receptors. Finally, the application of monoclonal antibodies to immunohistochemistry and radionuclide imaging also may provide new areas of diagnostic application for monoclonal antibodies in gynecologic oncology.

Measurement of human chorionic gonadotropin‐related immunoreactivity in serum, ascites and tumour cysts of patients with gynaecologic malignancies

“…Ovarian carcinoma-associated antigen 125 (CA 125), although of limited specificity, is the best marker for ovarian cancer to date and is able to detect over 80% of patients with advanced disease [5]. Ovarian carcinoma-associated antigen 125 (CA 125), although of limited specificity, is the best marker for ovarian cancer to date and is able to detect over 80% of patients with advanced disease [5].…”

“…Any potential tumour marker has to be evaluated in the context with other parameters available. Ovarian carcinoma-associated antigen 125 (CA 125), although of limited specificity, is the best marker for ovarian cancer to date and is able to detect over 80% of patients with advanced disease [5]. For other substances however, such as a-fetoprotein (AFP), carcinoembryonic antigen (CEA) [23] and squamouscell-cancer antigen (SCC) [24], clinical utility is less certain, and an equally promising marker for endometrial or cervical cancer has not been identified.…”

Prediction of a high-risk group based on postoperative nadir CA-125 levels in patients with advanced epithelial ovarian cancer

“…As a result, there has been considerable interest in developing predictive markers to assess the risk of a relapse in advanced EOC patients. The most famous biomarker in EOC is CA-125, which has been used in both diagnosis of the disease and monitoring of treatment [4-6]. Recent evidence indicates that the nadir CA-125 level after completion of primary treatment was associated with prognosis [7-11].…”