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The difficulty in clinical assessment of patients with ovarian cancer has led to a search -for a sensitive tumour marker. The tumour associated antigen CA125 is thought to be the most useful currently available (Bast et al., 1983; Milford Ward, 1987). It is present in the tumour tissue of over 80% of ovarian carcinomas at first laparotomy (Kabawat et al., 1983; Koelma et al., 1987; Maughan et al., 1988). Serum antigen levels are elevated in over 60% of patients and appear to correlate with the clinical course of the disease (Bast et al., 1983; Canney et al., 1984; Fish et al., 1987). Elevated serum levels after chemotherapy have been found to predict for the presence of residual disease at second laparotomy (Niloff et al., 1985; Alvarez et al., 1987; Fish et al., 1987). However, one limitation of serum CA125 monitoring is that the majority of patients with serum levels falling into the normal range after chemotherapy still have residual disease at second laparotomy (Niloff et al., 1985; Fish et al., 1987). The reason for this phenomenon is unclear but one possibility is that chemotherapy selectively kills tumour cells that produce CA125. In order to investigate this, the present study examines tumour material from patients with residual disease at second laparotomy and compares antigenic staining before and after chemotherapy. Thirteen patients (mean age 52.7 years), who had residual tumour after first laparotomy (lap 1), received 5-monthly courses of platinum therapy (cisplatin 100mgm -2 in 11, carboplatin 400mg m-2 in two). Thereafter they had no detectable disease on clinical and ultrasound examination and were assessed at a second laparotomy (lap 2). The patients were reclassified according to the findings at lap 2 as having residual disease of 2-10cm (n=4), <2cm (n=7) or as CR + (disease present on peritoneal washing only,

CA125 in ovarian tumour tissue at second laparotomy