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Background: Ovarian carcinoma is a silent killer because it presents in advanced stage. In India, it ranks third after carcinoma cervix and breast. Incidence of ovarian cancer is 5.4-8.0 per 100,000 in India. Various versions of risk of malignancy index have been studied to show its validity in different settings. We have studied third version of risk of malignancy index in a resource poor setting in India.Methods: In this prospective observational study 74 perimenopausal and postmenopausal women with ovarian mass were recruited. Menopausal score (M), Ultrasonography score (U) and CA-125 are components of Risk of Malignancy Index 3. Patients underwent preoperative ultrasonography and CA-125 level was assessed. Scores of M 1-3, U 1-3 and absolute value of CA-125 was multiplied. This product was value of Risk of Malignancy Index 3. If it is less than 250 it suggests absence of malignancy and more than 250 strongly suggests malignancy. Results were confirmed by histopathology.Results: Fifty six percent women were cancer positive. Ovarian malignancy was more common in postmenopausal age group. Ultrasonography and CA-125 had high sensitivity of 90% but poor specificity. Risk of malignancy index 3 had a sensitivity, specificity, positive predictive value and negative predictive value of 90%, 91%, 78% and 96% respectively at a cut off value of 250.Conclusions: Risk of malignancy index was concluded to be a multimodal approach with better diagnostic scoring index in preoperative stage in women of ovarian masses. It is simple and easily applicable clinical tool in resource poor setting.
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Background: The objective of this study is to evaluate the predictive value of serum CA-125 changes in the management of patients undergoing neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS) in advanced epithelial ovarian carcinoma (EOC).Methods: A retrospective hospital-based study of patients with advanced epithelial ovarian cancers (stage III and IV) was conducted at Department of Obstetrics and Gynecology in Gujarat Cancer and Research Institute, Ahmedabad, for two years. Total 50 patients were treated with NACT followed by surgical cytoreduction and followed up till August 2010. Response to NACT, optimal cytoreduction rate and overall response rate were analyzed.CA 125 levels before (baseline) and after NACT were analyzed.Results: Out of 50, there were 43 patients (86%) with stage III disease and 7 (14%) with stage IV disease. Maximum 37(74%) patients had CA 125 levels >500 on presentation while none of the patients had baseline CA125 levels in the normal range (<35). Range of baseline CA 125 was 164-5394.All patients were given NACT and after NACT, out of 50 patients, 22(44%) patients had CA 125 values within the normal range (<35) while 23(46%) had values between 35 and 100. Thus, statistically significant difference (Z = 6.154, P<0.0001) was found between CA 125 level before and after NACT. Out of 45 patients with CA 125 <100, 35(77.8%) underwent optimal cytoreduction.Conclusions: Baseline (prechemotherapy) serum CA-125 levels are powerful indicators of the presence and extent of spread of disease while CA-125 level particularly <100U/ml after NACT strongly predicts optimal cytoreduction in advanced epithelial ovarian cancers.
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Objective To investigate the influence factors of serum CA125 level in patients with ovarian chocolate cysts,and to study the effect on serum CA125 level of interventional therapy.Methods A total of 103 patients with single unilateral chocolate cyst of ovary underwent interventional treatment.According the serum CA125 level before interventional therapy,the patients were divided into normal group (CA125≤35 U/ml) and abnormal group (35 U/ml＜CA125≤200 U/ml).The clinical indexes of patients and ultrasound characteristics of cyst were compared between the two groups.The changes of serum CA125 levels before and after interventional therapy were analyzed.Results The difference of the course of diseases,dysmenorrhea history,diameter of cysts had statistical difference between the two groups (all P＜0.05).There were no statistical differences of age,history of dilivery,abortion history,history of pelvic surgery,cyst location between the two groups (all P＞0.05).In abnormal group,the mean serum level of CA125 reduced at 3 months (P＜0.000 1) and 6 months (P ＜0.000 1) after interventional therapy.In the normal group,there was no significant difference of the mean serum level of CA125 before and after interventional therapy (all P＞0.05).Conclusion Serum CA125 level is influenced by dysmenorrhea history,course of disease,diameter of cysts.Ultrasound-guided interventional therapy has intervention effect on patients with abnormal serum CA125 level before interventional therapy.
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Objective To estimate the clinical value of diagnosing early ovarian cancer by using transvaginal color doppler sonography (TVCDS ) , combined with the levels of serum tumor markers HE 4 and CA125. Methods A total of 151 patients with adnexal masses admitted for elective surgery were selected .According to the postoperative pathologic results , they were divided into ovarian cancer group (group A, 48 cases) and ovarian benign lesions group (group B, 103 cases).All patients were examined by TVCDS and the determination of serum HE 4 and CA125 level before surgery . The results were compared with pathological diagnosis after surgery . Results Serum HE4 and CA125 levels of the patients in group A were higher than those in group B .TVCDS parameters S/D, PI and RI were significantly lower in group A than in group B .The accuracy , sensitivity , specificity , positive predictive value, negative predictive value of TVCDS and HE 4+CA125 in ovarian cancer diagnosis were 94 .70%, 93 .75%, 95 .15%, 90 .00%, 97 .03%, respectively .The values were higher than the value of the sepa -rate checks .Con clusion TVCDS combined determination of serum HE 4 and CA125 level is helpful to the improvement of clinical diagnosis in ovarian cancer .
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Objective To compare the curative effects of CT-guided ethanol injection and lauromacrogol injection into the sac cavity in treating ovarian endometriosis cysts. Methods A total of 86 patients with ovarian endometriosis cyst were enrolled in this study. The patients were divided into ethanol group (n=44) and lauromacrogol group (n=42). Under CT guidance, injections of ethanol or lauromacrogol into the sac cavity of ovarian endometriosis cysts were respectively performed for the patients of both groups. The patients were followed up for six months, and the curative effects and the complications were analyzed. Results Six months after the treatment, the cure rates of ethanol group and lauromacrogol group were 95.50%and 92.86%respectively, and no statistically significant difference in cure rate existed between the two groups (P>0.05). The preoperative serum CA125 levels of the ethanol group and lauromacrogol group were (48.42±23.68)μg/L and(49.21±22.83) μg/L respectively, and the post operative ones were (23.56±5.89) μg/L and (25.49± 6.10) μg/L respectively; the differences between the preoperative data and the postoperative data were statistically significant in both groups (P0.05). The incidence of postoperative complications in the lauromacrogol group was obviously lower than that in the ethanol group (P<0.05). The cure time in the ethanol group was shorter than that in the lauromacrogol group, although the difference was not significant after six months. Conclusion For the treatment of ovarian endometriosis cysts, CT-guided lauromacrogol injection into the sac cavity has reliable curative effect. Compared to ethanol injection, injection of lauromacrogol is safer and has fewer adverse reactions. Therefore, this technique should be recommended in clinical practice. Serum CA125 can be used as an indicator for the evaluation of curative effect.
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Endometriosis is described as a chronic inflammatory disease, characterized by endometrial-like tissue, found outside the uterine cavity which cause chronic pelvic pain, infertility,dysmenorrhea. The prevalence of endometriosis is difficult to determine accurately but in asymptomatic women, the prevalence of endometriosis ranges from 2- 22 %, depending on the population studied , in infertile women 20-50 % and in those with pelvic pain, between 40-50% (Balasch, 1996; Eskenazi, 2001; Meuleman, 2009).Endometriosis is found 7-10% of reproductive agewomen and 20-90% in with chronic pelvic pain, infertility cases. Pathogenesis of endometriosis is not yet fully understood but one potential cause of the disease is retrograde menstruation which results in the deposition of endometrial tissue into the peritoneal cavity. Today a composite theory of retrograde menstruation with implantation of endometrial fragments in conjunction with peritoneal factors to stimulate cell growth is the most widely accepted explanation for peritoneal endometriosis. Susceptibility to endometriosis is thought to depend on the complex interaction of genetic, immunologic, hormonal and environmental factors. To determine prevalence and severity of clinical symptoms, compare meta-analysis to changes the clinical value of serum CA-125 and peritoneal fluid cytology in women with endometriosis of Ulaanbaatar city. We had selected total of 60 woman with endometriosis which were registered from January to December 2014 in gynecologic clinic of First Maternity Hospital. The research group registered in questionnaire with 28 questions. During the inspection laboratory analysis of serum CA-125, ultrasound analysis and peritoneal fluid cytology were done. Assessment of pelvic pain by means of a 10-point linear analog scale / pain score/ which provided by International Pain Association. The research result was worked out by prospective method. Average age of patients 33.4±8.9. Pain location: Chronic pelvic pain 30%; Dysmenorrhea 28.3%; Dysparunea 10%; Pain during defecation 6,7%; Without pain -25%. Average level of Serum СА125 was 38.13±20.6. Location of endometriosis: adenomyosis - 8.4%, endometrioma-15% endometriotic lesion at cul de suc 68.3%, rectal involment 1.7%, tubal lesion-3.3%, combined 3,3%. 76.7% of surgery for endometriosis have done by laparoscopy and 23.3% by laparotomy. Ultrasound examination result: endometrioma d=0-2cm-1.7%, d= 3-5cm-36.2%, d=6-8cm-10.3%, d=9cm<-12.1%. Cytology result: Peritoneal fluid contains 75% of erythrocytes, mesothelial cells and it needs to further study.CONCLUSION:Most of patient /58.3%/ had chronic pelvic pain and dysmenorrhea. The severity of pain was significantly improved after operative laparoscopy. /p<0.05%/51,7% of patient had infertility problem.Value of serum CA-125 was higher in study group with large sized and not clear content ovarian endometrioma by ultrasound examination. /p<0.05%/The local environment of peritoneal fluid surrounding the endometriotic implant is immunologically dynamic and links the reproductive and immune systems. Peritoneal factors to stimulate cell growth is the most widely accepted explanation for peritoneal endometriosis. Peritoneal fluid contains a variety of free floating cells, including macrophages, mesothelial cells, lymphocytes, erythrocytes, eosinophils and mast cells. In our cytology results: peritoneal fluid contains 75% of erythrocytes, mesothelial cells.
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Objective To compare the clinical effects and influence on CA125,endometrial antibody of trip-torelin the treatment of endometriosis surgery endometriosis surgery,to provide reference for clinical treatment. Methods 60 patients with endometriosis surgery were randomly divided into 30 cases of I group and 30 cases of II group,I group was treated with mifepristone on the first days after menstruation 12.5mg/d,qd,II group was given triptorelin 3.75mg,every 28 days for 1 times,treated for 3 months,the symptoms and signs before and after treatment were observed,then menstruation and dysmenorrhea score were evaluated,Elbow vein blood was taken out for calculat-ing CA125 and serum antiendometrial antibody,the clinical efficacy were evaluated and the adverse reactions were observed,all patients were followed up for 1 years,then 1 years cumulative pregnancy rate were recorded.Results The CA125,EMab,menstrual score,dysmenorrhea score of I group and II group after the treatment were (18.2 ±2.8)U /mL and (8.8 ±3.2)U /mL,(405.2 ±141.1)pg/mL and (202.1 ±79.8)pg/mL,(18.85 ±6.32)score and (7.68 ± 4.19)score,(1.91 ±0.35)score and (0.95 ±0.63)score,all index of both group after treatment were significantly lower than those before treatment(t =8.433 and 14.824,7.659 and 14.578,20.772 and 26.286,15.853 and 19.513,P 0.05);the irregular vaginal bleeding rate of I group was 23.33%,the II group were 3.33%,χ2 =5.192,P <0.05.Conclusion Triptorelin and mifepristone has same clinical effect in endometriosis postoperative,but triptorelin can reduce more effectively the CA125 and anti endometrium antibody,abnormal vaginal bleeding and reduce dysmen-orrhea postoperative,postoperative recurrence rate and pregnancy rate is good,can be used as a recommended drugs in the treatment patients with endometriosis surgery.
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Objective To investigate the changes of CA125 level with intra-abdominal tumor(epithelial ovarian cancer ,fallopian tube cancer and peritoneal cancer ) before and after chemotherapy serum and their effect on the prognosis of patients and their the clinical predictive value .Methods 174 cases(107 cases of epithelial ovarian cancer ,35 cases of fallopian tube cancer ,and 32 cases of peritoneal cancer) with peritoneal cancer patients were selected from January 2007 to January 2008 .The percentage decrease of ser-um CA125 were calculated after 3 courses of chemotherapy and CA125 decreased level of sensitivity with chemotherapy were ana-lyzed .The different levels of CA125 of median survival time and median survival time were compared .Results After chemothera-py ,CA125 decreased ≥ 75% in 42 cases ,decreased from 51% to 75% in 62 cases ,decreased from 25% to 50% in 32 cases ,and de-creased less than 25% in 38 cases .In CA125 decreased ≥ 75% group ,the chemotherapy effects was better than the other groups (P<0 .05) .Univariate analysis showed that the decrease proportion of CA 125 was positively correlated with chemotherapy effect (r=0 .396 ,P=0 .000) .Using the Kaplan-Meier method ,the patient's survival rate and median survival time were caculated and it showed that the 5 years survival and median survival time were significantly better in group CA 125 decline ≥ 75% than the other groups(P<0 .05) .Univariate analysis shows that the CA125 decline proportion of patients and long term efficacy was positively correlated(r=0 .412 ,P=0 .000) .The COX risk model analysis showed that FIGO stage ,CA125 level and the effect of chemothera-py were independent prognostic risk factors .Conclusion The level of CA125 is the independent risk factor of epithelial ovarian cancer ,fallopian tube cancer and peritoneal cancer prognosis .CA125 decline proportion could be used to know the effect of chemo-therapy and long term treatment ,and be the prognosis indicators for patients with intra abdominal tumor .
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PURPOSE: Mycobacterium tuberculosis is endemic in Korea. Because tuberculous peritonitis is characterized by ascites, abdominal pain, abdominal mass and elevation of serum CA-125, it can be confused with ovarian malignancies. The aim of this study was to evaluate the significance of serum CA-125 level in the differential diagnosis of tuberculous peritonitis and ovarian malignancy in a Mycobacterium tuberculosis-endemic area. MATERIALS AND METHODS: The medical records of patients diagnosed with tuberculous peritonitis (n=48) or epithelial ovarian malignancy (n=370) at Samsung Medical Center from January 2000 to October 2009 were retrospectively reviewed. RESULTS: Median serum CA-125 level in the epithelial ovarian cancer group was significantly higher than that in the tuberculous peritonitis group (p< or =0.01). Only one patient (2.1%) in the tuberculous peritonitis group had a serum CA-125 level over 2000 U/mL. However, 109 patients (29.5%) in the epithelial ovarian cancer group had a serum CA-125 level over 2000 U/mL. At the CA-125 ranges of 400 to 599 and 600 to 799, the proportions of those with tuberculous peritonitis were 24% and 21.9%, respectively. At a serum CA-125 level over 1000 U/mL, however, the proportion of tuberculous peritonitis was much lower (2.1%). CONCLUSION: Tuberculous peritonitis should be considered in the evaluation of female patients with ascites and high serum CA-125.
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Female , Humans , Ascites/blood , CA-125 Antigen/blood , Diagnosis, Differential , Multivariate Analysis , Ovarian Neoplasms/blood , Peritonitis, Tuberculous/blood , Republic of Korea , Retrospective StudiesABSTRACT
Objective: To investigate the clinical features and survival factors of primary fallopian tube car-cinoma. Methods: We used Kaplan-Meier survival analysis, single factor analysis and multivariate analysis to evaluate the prognostic factors of 40 patients diagnosed with primary fallopian tube cancer. Results: The aver-age age of the patients was 51 years and all of them received surgery. There were 29 (72.5%) stage Ⅰ or Ⅱ patients, 11 stage Ⅲ or Ⅳ patients. Thirty-one (77.5%) patients were diagnosed with poorly differentiated tu-mors and 22 (55%) patients had serous adenocarcinoma. Thirty-seven patients received PAC/PC or TC che-motherapy after surgery. Six patients (15%) had recurrences within 23 to 56 months after surgery. The medi-an survival of Ⅰ～Ⅱ and Ⅲ～Ⅳ stage patients was 79 and 35 months, respectively. The total 5-year survival was 58% and 0 (P=0.005). Univariate and multivariate analysis showed that stage (Ⅰ～Ⅱ vs. Ⅲ-Ⅳ), grade (G_1+G_2 vs. G_3), residual disease after surgery (none, <1cm vs. >1cm) were significant factors affecting surviv-al. In accordance with the formula to calculate the half-life of CA125 and compare preoperative serum CA125 with the value at 3 weeks after surgery (T_(1/2)>3 week, T_(1/2)<3 week), the 5-year survival was 78% and 50%, re-spectively (P=0.036). Conclusion: Special attention should be paid to the joint screening of primary fallopian tube cancer in clinical practice in order to avoid misdiagnosis. The consecutive measurements of serum CA-125 level may have significant value as a prognostic indicator for patient survival.
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OBJECTIVE: This prospective study was conducted to determine the correlation between preoperative serum CA 125 levels and the presence of surgicopathologic prognostic factors in endometrial cancer. Subsequently, the study also aimed to determine the CA 125 cutoff value which best predicted the prognostic factors to which it had a significant correlation. METHODS: Patients diagnosed with endometrial cancer at a tertiary gynecologic oncology unit from October 2006 until July 2008 who were eligible for primary surgical treatment were included in this analysis. Blood was extracted for serum CA 125 determination using a chemiluminescent enzyme immunoassay (CLEIA) prior to surgery. All patients underwent exploratory laparotomy, peritoneal fluid cytlogy, extrafascial or radical hysterectomy with bilateral salpingooophorectomy, bilateral pelvic lymph node dissection and para-aortic lymph node sampling. All specimens were examined for tumor differentation, lymphovascular space invasion, depth of myometrial invasion, cervical, adnexal, and vaginal involvement pelvic and para-aortic lymph node metastases, and peritonneal fluid cytology. Statistical analysis was performed using the Pearson r correlation test to evaluate the correlation of preoperative serum CA 125 with the different surgicopathologic prognostic factors mentioned. A receiver operating characteristics curve (ROC) was used to determine the optimal cutoff value of preoperative CA 125. Sensitivity, specificity, accuracy and likehood ratios were calculated. RESULTS: A total of 90 patients with endemetrioid type endometrial adenocarcinoma underwent co,plete surgical staging from October 2006 until July 2008. Of the different surgicopathologic prognostic factors, pre-operative serum CA 125 was demonstrated to be significantly correlated with deep myometrial invasion (correlation coefficient 0.24, p=0.02), adnexal metastasis (correlation coefficient 0.26, p=0.01), pelvic lymph node involvement (correlation coefficient 0.31, p=0.01) and para-aortic lymph node involvement (correlation coefficient 0.43, p 0.01. The test likewise significantly correlated with the presence of extrauterine disease with a coefficient of 0.26 (p=0.01). A cutoff value of 55 U/ml has been calculated to predict extrauterine spread with a sensitivity of 53.85% , specificity of 84.38%, and accuracy of 75.56%. Using this cutoff, the odds of the positive test is 3.44, and the odds of negative test is 0.54. CONCLUSION: Pre-operative serum CA 125 has a statistically significant correlation with the presence of deep myometrial invasion, adnexal metastasis, pelvic and para-aortic lymph node involvement, and extrauterine disease at a determined cutoff value of 55U/mL. It is recommended that serum CA 125 determination be adopted as an integral part of the routine pre-operative work-up of patients with endometrial cancer.
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Humans , Ascitic Fluid , Laparotomy , Prognosis , Endometrial Neoplasms , Lymph Node Excision , Lymphatic Metastasis , Lymph Nodes , Hysterectomy , Immunoenzyme Techniques , AdenocarcinomaABSTRACT
Struma ovarii is a rare form of ovarian neoplasm, composed entirely or predominantly of thyroid tissue and generally a benign germ cell tumor of the ovary. The tumor usually present with findings of an asymptomatic mature mass. Despite containing thyroid tissue, only 5% of struma ovarii have features of hyperthyroidism. Ascites have been reported in approximately 15-20% of all cases. The combination of struma ovarii and elevated CA125 has rarely been reported. We experienced an case of benign struma ovarii showing the clinical characteristics such as massive ascites, high serum CA125 level and a complex pelvic mass strongly suggestive of the malignancy. So, we report this case with a brief review of literature.
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Female , Ascites , Hyperthyroidism , Neoplasms, Germ Cell and Embryonal , Ovarian Neoplasms , Ovary , Struma Ovarii , Thyroid GlandABSTRACT
OBJECTIVE: In this retrospective study, we analyzed the clinicopathologic characteristics of advanced serous epithelial ovarian cancer and evaluated the prognostic factors which have an impact on survival of patients with epithelial ovarian cancer. We also compared several analyzing methods of CA 125 for predicting prognosis of advanced serous epithelial ovarian cancer. METHODS: A total of 57 patients with advanced serous epithelial ovarian cancer who were treated at Samsung Medical Center between Aug. 1995 and Jul. 2000 were included. Medical records including pathologic reports were reviewed to identify clinicopathologic characteristics and serum levels of CA 125. Five different methods of analyzing serum CA 125 were compared for predicting the prognosis of advanced serous epithelial ovarian cancer. Survival curves were analyzed by Kaplan-Meier method and Cox proportional hazards model. RESULTS: The median age of all patients was 54.2 years. In univariate analysis, age, FIGO stage, grade, residual tumor and ascites showed no significant correlation with prognosis. Among five different analyzing methods of serum CA 125 levels, normalization after 3rd chemotherapy was correlated with improved 5-year survival rate (p=0.026). CONCLUSION: This study showed that normalization of serum levels of CA 125 after 3rd chemotherapy is useful for predicting prognosis of advanced serous epithelial ovarian cancer patients.
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Humans , Ascites , Drug Therapy , Medical Records , Neoplasm, Residual , Ovarian Neoplasms , Prognosis , Proportional Hazards Models , Retrospective Studies , Survival RateABSTRACT
OBJECTIVE: The purpose of this study was to determine the significance of preoperative serum CA-125 level of primary epithelial ovarian carcinoma with respect to prognostic factors (histologic grade, tumor stage, success of cytoreductive operation) and to assess the relationship between the changes of serum CA-125 level and 5-year survival rate after the cytoreductive operation and chemotherapy. METHODS: We retrospectively investigated the results of 101 patients with primary epithelial ovarian cancer staged over IC, who had been diagnosed and treated at Kyung-Hee University Medical Center from January 1991 to April 2003. They were managed with cytoreductive operation and chemotherpy. They were monitored by serum CA-125 level serially during treatments. RESULTS: There were significant differences of preoperative serum CA-125 level in histologic types, histologic grades, presence of ascites, presence of lymph node involvement, success of cytoreduction and success of 5-year survival (P0.05). There were significant differences of 5-year survival rate in groups divided by pre- and postoperation serum CA-125 level (P<0.05). And significant differences were shown between serum CA-125 values and 5-year survival rate in three cycles of chemotherapy (P<0.05). CONCLUSION: Serum CA-125 level is a valid tumor marker in predicting the responsiveness of cytoreduction and combined chemotherapy in epithelial ovarian cancer. Measurement of serum CA-125 levels during treatment might permit an early change to optimal forms of therapeutic management or alternatives.
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Humans , Academic Medical Centers , Ascites , Drug Therapy , Lymph Nodes , Ovarian Neoplasms , Retrospective Studies , Survival RateABSTRACT
OBJECTIVE: The study was carried out to assess whether a sudden rise in the serum CA 125 level might predict spontaneous abortion in the first trimester. In the process, we assessed the clinical value of maternal CA 125 in patients with missed abortion and evaluate the prognostic significance of CA 125 in early normal pregnancies, threatened abortions. The purpose of this study was to prospectively compare serum CA 125 levels among women who abort in the first trimester, who experience threateneda bortion and who go through normal pregnancy. METHODS: Between March 2001 and September 2001, a total of 133 patients were observed in the Department of Obstetrics and Gynecology at CHA Hospital. Fifty-eight with missed abortions, forty-five with threatened abortions and thirty normal pregnancies (no history of endometriosis or ovarian mass) were evaluated during gestational age 6 to 12 weeks and maternal serum samples were collected. All patients were sonographically assessed and CA 125 values were compared. RESULTS: There was no statistically significant difference in the CA 125 levels between the spontaneous aborted patients and the patients without abortion: missed abortion, 72.9 +/- 102.0IU/ml (range 7.3-487.6); threatened abortion, 46.6 +/- 37.9IU/ml (range 13.9-206.1); normal pregnancy, 63.4 +/- 61.2IU/ml (range 13.8-62.8). CONCLUSION: Our study shows that serum CA 125 levels are not predictive of spontaneous abortion in the first trimester and failed to discriminate among missed abortions, threatened abortions, and normal pregnancies.
Subject(s)
Female , Humans , Pregnancy , Abortion, Missed , Abortion, Spontaneous , Abortion, Threatened , Endometriosis , Gestational Age , Gynecology , Obstetrics , Pregnancy Trimester, First , Prospective StudiesABSTRACT
OBJECTIVES: This study was performed to identify the validity of serum CA125 level for assessing responsiveness to combined chemotherapy in patients with epithelial ovarian cancer. MATERIALS AND METHODS: 30 patients with epithelial ovarian cancer who had received postoperative combined chemotherapy (paclitaxel and cisplatin) at Department of Obstetrics and Gynecology, Korea University Medical Center, from February, 1996 to July, 2000 were included. We analyzed the relation between the responsiveness criteria of WHO and the change in serum CA125 level. RESULTS: 1. There was a tendency that patients with more advanced stage(stage 1-4) had higher serum CA125 level without significant differences. 2. The percentage of patients who responded to paclitaxel and cisplatin was 46.7%(14/30) by WHO criteria and 56.7%(17/30) by serum CA125 level. 3. The sensitivity and specificity of serum CA125 level in the prediction of response were 78.6% and 62.5% respectively. 4. In a living group, the changes of percentage value in CA125 level were higher at 2nd, 3rd and 4th chemotherapy cycle than in an expired group(p<0.05). 5. There was a tendency that the responsiveness based on WHO criteria and CA125 had positive correlation(p=0.0865). 6. There was a tendency that the responsiveness based on serum CA125 level and patient`s survival had positive correlation(p=0.1454). CONCLUSIONS: Serum CA125 level is a valid tumor marker in assessing the responsiveness to combined chemotherapy which can be used with or instead of the WHO criteria in epithelial ovarian cancer.
Subject(s)
Humans , Academic Medical Centers , Cisplatin , Drug Therapy , Gynecology , Korea , Obstetrics , Ovarian Neoplasms , Paclitaxel , Sensitivity and SpecificityABSTRACT
Objective To study the value of serum CA 125. in the evaluation of pulmonary tuberculosis activity and treatment effect.Method This study included 90 subjects who were divided into three groups.Group 1 consisted of 30 patients with active pulmonary tuberculosis.Group 2 included 30 patients with inactive pulmonary tuberculosis.There were 30 healthy subjects in group 3.While measurement of serum CA 125. level were performed only once in groups 2 and 3,CA 125. levels were measured four times in group 1 before and after the treatment.Result The serum CA 125. concentration in group 1 was higher than in the other groups (P0.05).CA 125. levels in group 1 showed a significant decrease after treatment (P
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OBJECTIVE: The object of this study was to compare the diagnostic accuracy of a sonographic morphologic scoting system, the serum CA-125 assay, and a combination of both in patients undergoing laparotomy for a clinically diagnosed adnexal mass. METHODS: In 129 consecutive patients, the morphology of the mass was evaluated and scored by the morphologic scoring system of Sassones using transabdominal or transvaginal sonography and blood samples were obtained for CA-125 assay before planning surgery, RESULTS: The sensitivity of the sonographic morphologic scoring system was 90.6%, the specificity 84.5%, the positive predictive value 65.9%, and the negative predictive value 96.5%, compared with 68.8, 77.3, 50.0, and 88.2% for CA-125 and 96.9, 66.0, 48.4, and 98.5% for the two tests combined, respectively. Only one case of serous borderline ovarian tumor was missed when the two tests were combined. The sensitivity and mean value of the serum CA-125 increased with the stage of ovarian cancer. CONCLUSION: The combination of sonographic findings with a serum CA-125 assay was more sensitive, but less specific, than sonography or the serum CA-125 assay alone in predicting the malignancy of an adnexal mass. The serum CA-125 level generally reflected the stage of the disease. We think that it is reasonable to check the serum CA-125 only in cases of ovarian malignancy diagnosed by sonography.
Subject(s)
Humans , Diagnosis , Laparotomy , Ovarian Neoplasms , Sensitivity and Specificity , UltrasonographyABSTRACT
Measurement of the serum CA 125 level as a tumor marker in patients with epithelial ovarian cancer has been widely used to monitor disease status and predict survival of patient. While a number of benign gynecologic as well as benign or malignant non-gynecologic conditions are associated with elevations of serum CA 125 levels, the established normal range describes a healthy population of women. Because the metabolism and clearance of CA 125 is not well understood and mild or moderate degrees of renal impairment frequently occurs in ovarian cancer patients during treatment or course of disease, it is valuable to investigate the effect of impaired renal function on serum level of CA 125. Eighty-nine women on hemodialysis who had no other definite cause to elevate serum CA 125 level were selected at random. The age of the patients ranged from 19 to 83 and renal disease was secondary in most cases to diabetes mellitus, hypertension or glomeru-lonephritis. The creatinine clearance was less than 10cc/min for all patients. (continue)
Subject(s)
Female , Humans , Creatinine , Diabetes Mellitus , Hypertension , Metabolism , Ovarian Neoplasms , Reference Values , Renal DialysisABSTRACT
Objective To assess preoperative value of serum CA 125 determination for uterine endometrial carcinoma including myometrial invasion, lymph node metastasis, surveillance and recurrence of the carcinoma. To explore the relationship between serum CA 125 levels and pathological grades of endometrial carcinoma. Methods Serum CA 125 levels were determined by ELISA test in 67 cases of postmenopausal endometrial carcinoma. Results There were significant differences in CA 125 levels between patients with clinical stage Ⅲ、 Ⅳ cases and clinical stage Ⅰ, Ⅱ ( P