ABSTRACT
The objective of this work was to judge the usefulness of preoperative measurement of the amino-terminal propeptide of type III procollagen [PIIINP] as a tumor marker. Seventy patients with mean age 40 +/- 8 years and 15 healthy ovulating women with mean age 25 +/- 5 years, served as a control group, were included in this study. The patients group was classified into four subgroups: Subgroup I included 15 patients with salpingo-oophoritis, subgroup II included 10 patients with leiomyoma, subgroup III included 15 patients with benign ovarian cyst and subgroup IV included 30 patients with ovarian cancer. Serum progesterone and PIIINP were measured during follicular and luteal phases for control group. Serum amino-terminal propeptide of type III procollagen [PIIINP] and CA125 were measured preoperatively during follicular phase, using different immunochemical techniques for both controls and patients. The results revealed that levels of PIINP in healthy ovulating women were within the reference range [up to 6.7 mug/L]; however, there was significant rise in PIIINP during luteal phase compared to follicular phase [p <0.01]. There was positive correlation between PIIINP and progesterone in the luteal phase [r=0.95, p <0.001]. Levels of PIIINP were shown to be lowest in healthy women, intermediate in women with salpingo-oophoritis, in cases of leiomyoma and benign ovarian cysts, but significantly higher in cases with ovarian cancer. The sensitivity of PIIINP to predict ovarian cancer was 76.7% with specificity of 90.5% at a cut-off level of 55 mIU/ml. Using both PIIINP and CA125 the sensitivity went up to 92% and the specificity was 70%. In conclusion, PIIINP level is affected by ovarian hormones. There is positive correlation between serum PIIINP and progesterone in luteal phase in normal menstrual cycles. Preoperative estimation of amino-terminal propeptides of type III procollagen [PIIINP] is a good tool for detection of ovarian cancer and has a complementary value with CA125