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Differential diagnosis of ovarian cancer with tumour markers CA 125, CA 15‐3 and TAG 72.3
Author(s) -
Jacobs Ian J.,
Rivera Hector,
Oram David H.,
Bast Robert C.
Publication year - 1993
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.1993.tb15177.x
Subject(s) - medicine , malignancy , differential diagnosis , adnexal mass , gynecology , logistic regression , prospective cohort study , obstetrics and gynaecology , cancer antigen , ovarian cancer , cancer , gastroenterology , pathology , pregnancy , biology , genetics
Objective To determine the accuracy of tumour associated antigens CA 125, CA 15–3 and TAG 72.3 in the differential diagnosis of benign and malignant pelvic masses and to compare the results with a previously defined risk of malignancy index (RMI). Design Retrospective analysis of samples collected during a prospective observational study. Setting Department of Obstetrics and Gynaecology, the Royal London Hospital and Duke University Medical Center. Subjects One hundred and forty‐three consecutive patients undergoing surgery for an adnexal mass. Method Tumour marker levels were determined by radio‐immunoassay in stored serum samples obtained from 143 study subjects. Results The highest diagnostic accuracy of the tumour marker panel was achieved by defining a positive result as elevation of any two of CA 125 (>30 u/ml), CA 15–3 (>30 u/ml) and TAG 72.3 (> 10 u/ml), (sensitivity 66.7%, specificity 93.1%). Similar diagnostic accuracy could be achieved by CA 125 alone using an upper limit of 50 u/ml (sensitivity 66.7%, specificity 94.1%). Inclusion of CA 15–3 or TAG 72.3 in stepwise logistic regression analysis did not improve the discriminative performance of the RMI. Conclusion The risk of malignancy index incorporating CA 125, menopausal status and ultrasound is superior to the panel of three tumour markers for pre‐operative differential diagnosis of the pelvic mass.