Significance of CA 125 serum level in discrimination between benign and malignant masses in the pelvis

Milojković, Miodrag; Hrgović, Zlatko; Hrgović, Igor; Jonat, W.; Maass, Nicolaì; Buković, Damir

doi:10.1007/s00404-002-0411-7

Cited by 26 publications

(18 citation statements)

References 15 publications

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“…Previous markers which have been used for OVC, including CA125 and HE4, only detected OVC at the late stages of cancer development and lacked efficiency during early tumor growth (13,14). …”

Section: Discussionmentioning

confidence: 99%

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Differential levels of L-homocysteic acid and lysophosphatidylcholine (16:0) in sera of patients with ovarian cancer

Kim

et al. 2014

Oncology Letters

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Ovarian cancer (OVC) is one of the most difficult types of cancer to detect in the early stages of its development. There have been numerous attempts to identify a biomarker for OVC; however, an accurate diagnostic marker has yet to be identified. The present study profiled OVC candidate metabolites from the serum to identify potential diagnostic markers for OVC. Data regarding low-mass ions (LMIs) in the serum were obtained using matrix-assisted laser desorption/ionization (MALDI)-time-of-flight analysis. MALDI-mass spectrometry (MS) analysis of each serum sample was repeated six times in order to reduce the likelihood of experimental errors. The intensity of the LMI mass peaks were normalized using total peak area sums. The normalized intensity of LMI was used in principal component analysis-discriminant analysis to differentiate between 142 patients with OVC and 100 healthy control participants. Liquid chromatography-MS/MS was used to identify the selected LMIs. Extracted ion chromatogram analysis was used to measure the relative quantity of candidate metabolites from the LMI mass peak areas. The concentration of common metabolites in the serum was determined using ELISA. The top 20 LMI mass peaks with a weigh factor over 0.05 were selected to distinguish between the patients with OVC and the controls. Among the LMIs, two with 184.05 and 496.30 m/z were identified as L-homocysteic acid (HCA) and lysophosphatidylcholine (LPC) (16:0), respectively. The relative quantity of LPC (16:0) was found to be decreased in the OVC serum (P=0.05), while the quantity of HCA was observed to be significantly higher in the OVC serum (P<0.001). HCA was not detected in 59 cases out of the 63 control participants; however, the majority of the cases of OVC (16/25) exhibited significantly higher quantities of HCA. When the cutoff was 10 nmol/ml, the sensitivity and specificity of HCA were 64.0 and 96.9%, respectively. The level of LPC (16:0) was significantly correlated with tumor grade (P=0.045). HCA and LPC (16:0) showed correlation with stage and tumor histology, but the limited sample size resulted in a lack of statistical significance. The findings of the present study suggest that HCA may have potential to be a biomarker for OVC. The stratified screening including LPC (16:0) did not significantly increase the power for OVC screening; however, the present study showed that profiling LMIs in serum may be useful for identifying candidate metabolites for OVC screening.

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Section: Discussionmentioning

confidence: 99%

“…For example CA125 was discovered 20 years ago and has been used widely as an OVC marker since (13). However, CA125 has low specificity and sensitivity during the early stages of OVC (6,9,14), thus an ideal marker has yet to be elucidated.…”

Section: Introductionmentioning

confidence: 99%

Differential levels of L-homocysteic acid and lysophosphatidylcholine (16:0) in sera of patients with ovarian cancer

Kim

et al. 2014

Oncology Letters

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“…The role of CA 125 in differentiating cancer cases from benign condition is also reported in pelvic lesions and non-Hodgkin lymphomas [14,15].…”

Section: Discussionmentioning

confidence: 95%

CA 125: A potential tumor marker for gallbladder cancer

Chaube

Tewari

Singh

et al. 2006

Journal of Surgical Oncology

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“…Large screening trials for ovarian cancer indicate that using a CA125 cutoff value of 30 U/ml has good sensitivity, but inadequate specificity for detecting preclinical disease [15] . Because of concern about the specificity of the test, other reports suggested that the upper limit of the normal range for ovarian cancer screening should be 65 U/ml [13] . Mancuso et al [16] pointed out that, in the prediction of a malignant adnexal mass, the best results were obtained from the association between CA125 and menopause, probably because in this period there is a lower incidence of benign diseases related to this marker so that an increase in the CA125 level is more likely associated with a malignant mass.…”

Section: Discussionmentioning

confidence: 99%

“…Although a single CA125 measurement provides no advantage in the early detection of ovarian cancer in asymptomatic postmenopausal women [12] , a growing body of evidence has accumulated that preoperative determination of CA125 is a very useful method to discriminate between benign and malignant masses in the pelvis [13] . In one of the reported evaluations of CA125 screening, the sensitivity and specificity of CA125 alone for the diagnosis of ovarian cancer, at a cutoff level of 35 U/ml, were 83 and 82%, respectively [14] .…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Ovarian Cancer among Women with a CA125 Level of 35 U/ml or Less

Kobayashi

Yamada

Sado

et al. 2007

Gynecol Obstet Invest

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Background: The optimal upper limit of the normal range for CA125 in ovarian cancer screening is unknown. We investigated the prevalence of ovarian cancer among women in the Shizuoka Cohort Study on Ovarian Cancer Screening (SCSOCS) trial who had an abnormal ultrasound (US) and a CA125 level of 35 U/ml or less. Methods: Of 48,027 women enrolled in the SCSOCS trial, 40,801 women never had a CA125 level of more than 35 U/ml, and underwent transvaginal US. Results: Among the 40,801 women (age range 45–85 years), 4,859 women had an abnormal transvaginal US examination (category 1 [simple morphology], 4,741 women, and category 2 [complex morphology], 118 women). Of the 4,859 women, 981 (912 with the category 1 and 69 with the category 2) had a surgery. Of the 981 women, ovarian cancer was diagnosed in 8 (0.815%), and 5 of these 8 cancers (63%) were in stage I. The prevalence of ovarian cancer with abnormal US was 0.207% among women with a CA125 level of up to 15 U/ml, 0.488% among those with values of 15–20 U/ml, 0.685% among those with values of 20–25 U/ml, 2.04% among those with values of 25–30 U/ml, and 6.12% among those with values of 30–35 U/ml. Conclusions: Surgery-detected ovarian cancer is not rare among women with CA125 levels of 35 U/ml or less – levels generally thought to be in the normal range.

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Significance of CA 125 serum level in discrimination between benign and malignant masses in the pelvis

Abstract: . Preoperative determination of CA 125 is a very useful method to discriminate between benign and malignant masses in the pelvis.

Cited by 26 publications

References 15 publications

Differential levels of L-homocysteic acid and lysophosphatidylcholine (16:0) in sera of patients with ovarian cancer

Differential levels of L-homocysteic acid and lysophosphatidylcholine (16:0) in sera of patients with ovarian cancer

CA 125: A potential tumor marker for gallbladder cancer

Prevalence of Ovarian Cancer among Women with a CA125 Level of 35 U/ml or Less

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