ABSTRACT
To evaluate the significance of including CEA in serum and tissues in the management protocol of patients with ovarian malignancies. Patients and The study included 68 patients divided into three groups: Group A included 21 patients with malignant ovarian tumors. Group B included three patients with borderline ovarian tumors. Group C included eight patients with benign ovarian tumors. Group D included 36 women without any apparent gynecologic disorder and acted as our control group. The serum level of CEA was measured in all patients in Groups A, B and C prior to treatment and at least 12 weeks following therapy. Formalin-fixed and paraffinembedded tissue blocks taken from two sites of the studied lesions were prepared. Immunohistochemical staining for CEA was performed for the studied tissues. All benign and borderline ovarian tumors had negative pre- and post-treatment serum levels of CEA[< 5 ng/ml] while 52.38% of malignant ovarian tumors had positive pre - treatment serum values. After treatment, all the malignant ovarian tumors were seronegative for CEA. The mean pre - treatment serum CEA level in malignant ovarian tumors [7.32 ng/ml] was significantly higher than that of the other groups. The mean post-treatment serum values and the mean difference in serum levels showed no significant differences between the three groups. The mean difference between pre- and post-treatment serum CEA was significant only in malignant ovarian tumors. A total of 12.5% of the benign ovarian tumors, and 42.86% of the malignant ones had a positive reaction for CEA tissue stain. The mean values of serum CEA before treatment were significantly higher in positively stained malignant ovarian tumors [P < 0.0001]. The mean difference in the s e rum CEA was significantly higher in positively stained malignant ovarian tumors [P < 0.0001]. The mean pre - treatment serum CEA and also the mean difference in s e rum levels showed significant progressive increase with the increase in degree of tissue stain of ovarian carcinomas. This study indicates that immunohistochemical identification of CEA in the tumor tissue and monoclonal antibodies quantitative measurement of CEA in human serum is a useful adjunct in the management protocol of patients with ovarian malignancies