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Pre‐operative discrimination between benign and malignant ovarian tumors using a combination of CA125 and CA15.3 serum assays
Author(s) -
Yedema C.,
Massuger L.,
Hilgers J.,
Servaas J.,
Poels L.,
Thomas C.,
Kenemans P.
Publication year - 1988
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.2910410813
Subject(s) - ovarian cancer , medicine , malignancy , ovarian tumor , tumor marker , ovarian carcinoma , cancer , ovary , gastroenterology , oncology , pathology
Abstract Serum levels of CA125 and CA15.3 were measured in 70 patients presenting with an ovarian neoplasm, of whom 38 had an ovarian malignancy and 32 a benign ovarian tumor. CA125 levels exceeded 35 U/ml in 71% of ovarian carcinomas and in 25% of benign ovarian tumors. In the entire group of 70 patients, CA125 levels (> 35 U/ml) were elevated in 35 patients, of whom 27 had ovarian cancer. CA15.3 levels were found to be elevated (> 30 U/ml) in 9% of benign ovarian tumors and in 50% of ovarian malignancies. Of 8 patients with a false positive CA125 (> 35) elevation, only one had an elevated CA15.3 level whereas in 27 correct positive patients 19 also had elevated CA15.3 levels. Of all 20 patients with both markers elevated, 19 patients (95%) had ovarian cancer. When a cut‐off level of 65 U/ml was used for the tumor marker CA125, all patients with simultaneous elevation of both markers were found to have an ovarian malignancy. Using a panel of CA125 (> 35 U/ml) and CA15.3 (> 30 U/ml) and requiring a simultaneous marker elevation, the sensitivity of the test decreased from 71% to 50% but the corresponding specificity of the test rose from 75% to 97%. Specificity was as high as 100% if in the same panel of tests a 65 U/ml cut‐off for CA125 was taken. A comparison of early stage 1‐11 ovarian cancer with benign ovarian tumors failed to demonstrate a discriminatory capacity of any test or test combination. We conclude that the use of a panel of tumor markers is advantageous in the pre‐operative discrimination of benign and malignant ovarian tumors, since the predictive value for malignancy of a combined marker elevation was as high as 100% in the population studied.