Ovarian and Uterine Cancer Markers

9. Ovarian Cancer

“…Immunohistochemical staining for CEA can be used to distinguish between endocer vical and endometrial adenocarcinomas: en docervical adenocarcinomas (except for the mesonephroid type) are CEA-positive, whereas endometrial adenocarcinomas, ex cept for areas of squamous metaplasia, are CEA-negative [12], In some studies, elevated levels of HCG have been observed in association with non trophoblastic gynecological cancers [13,14], but the levels do not follow the clinical course [14], Therefore, the measurement of HCG is not of clinical value in patients with nontrophoblastic gynecological cancer [1], Studies of alkaline phosphatase isoen zymes have indicated that the placental isoenzyme may be elevated in ovarian can cer [15], However, the assay has not been considered useful for the detection of early disease, nor does it reflect the disease stage [9], Some recently developed immunoenzymatic assays utilizing monoclonal antibodies [16][17][18] seem to be more specific and sensi tive for ovarian cancer than earlier ones.…”

“…Elevated serum carcinoembryonic anti gen (CEA) levels have been observed in 13-80% of patients with nontrophoblastic gyne cological cancer; the average incidence is 40% [1,9], Elevated levels are more com mon in advanced disease [10]. When the CEA assay is used sequentially to detect reccurrences of gynecologic cancers, a lead time of 11 weeks has been obtained [11].…”

“…Other placental proteins can also be used to monitor trophoblastic tumors, but assay of these antigens fails to yield information not available from HCG alone [ 1 ]. The levels of pregnancy-associated protein ('Schwangerschaftsprotein'; SP|) reflect trophoblastic diseases in the same way as HCG, but occa sional elevation of SP; levels may occur without any rise of HCG and without evi dence of trophoblast activity [7], Placental protein 5 is usually elevated in benign molar disease but not in choriocarcinoma [8].…”

“…Thus, early detec tion of residual disease often leads to com plete cure [1], The sensitivity of the HCG assay used should be at least 1-2 IU/1 and the cross-reactivity with luteinizing hor mone (LH) less than 1 %. Some recently de veloped HCG assays are 10-50 times more sensitive than methods used earlier and show a negligible cross-reactivity with LH [3,4], By these methods it is possible to measure HCG quantitatively in nonpregnant sub jects.…”

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

“…AFP, LDH, or TPA, have been detected in the blood of ovar ian cancer patients, but none of these tradi tional markers has proved to be generally use ful for monitoring disease progression or re gression [2][3][4][5], In the past 10 years, antibodies against many ovarian cancer-associated anti gens have been described [3][4][5][6][7], However, only a few of them arc useful, and of these CA 125 has shown the most clinical promise to date [4,[8][9][10]. Bast and Knapp [4] developed an assay based on a murine monoclonal anti body (OC 125) reacting with the CA 125 epi tope of a high molecular weight mucine-like protein.…”