Ca 125 Assay Used in Conjunction with Ca 15–3 and Tag-72 Assays for Discrimination Between Malignant and Non-Malignant Diseases of the Ovary

Abstract

It has previously been suggested by the authors that elevated serum CA 125 levels may be of value in discriminating malignant from non-malignant pathologies among women with pelvic masses. Enhancement of this discrimination capacity might be achieved by utilizing additional serum assays. To test this hypothesis CA 125, CA 15-3 and TAG-72 levels were determined in double-blind fashion on 219 sera from patients undergoing diagnostic laparotomy for pelvic masses at six gynecological departments in the Stockholm area. Patient diagnoses were verified by chart review. Of the 219 patients, 27 (12%) had non-mucinous ovarian carcinoma, of whom 26 (96%) had CA 125 levels of 35 U/ml or greater 23 (85%) had levels in excess of 65 U/ml. Of 27 patients with mucinous or borderline ovarian carcinoma and patients with other malignancies 18 (67%) had CA 125 levels greater than 35 U/ml. Of 165 women with non-malignant diagnoses 26 (16%) had CA 125 levels in excess of 35 U/ml and 8 (5%) greater than 65 U/ml. Using reference values of 35 U/ml, 30 U/ml and 10 U/ml for the CA 125, CA 15-3 and TAG-72 assay respectively, only 3 of 165 (2%) of non-malignant patients were categorized as positive, compared to 23 of 27 (85%) of those with non-mucinous ovarian carcinoma. Moreover, an analysis of postmenopausal women revealed that the combination of assays--in a model controlling for the effect of CA 125--increased the specificity for diagnosis of benign diseases in women with pelvic masses.

The role of ultrasound and tumour markers in the early detection of ovarian cancer

“…Extremely high specificity (98.9 %) was achieved when a positive result was defined as a CA125 level greater than 30 U/ml in combination with either a CA15.3 greater than 30 U/ml or a TAG 72.3 greater than 10 U/ml (Jacobs et al 1993b). These findings were confirmed by other workers (Einhorn et al 1989) who found the specificity for malignancy to be 98 % when all three antigens were elevated, compared with 83 % for CA125 used as a single test. However, by adding the two tests the sensitivity to discriminate malignant from benign diseases decreased to 69%.…”

Tumor Markers in Ovarian Malignancies

“…Einhorn et al evaluated CA125 concentrations together with those of CA15-3 and TAG-72 in 219 patients undergoing diagnostic laparotomy for pelvic masses. They found that the three tumor markers increased the specificity for detecting ovarian cancer but reduced the sensitivity of the CA125 assay [10]. Similar observations were made by Soper et al, who showed that by combining CA15-3 and TAG-72 measurements with CA125, the specificity for detecting ovarian cancer rose from 83% to 98%, but the sensitivity was reduced from 88% to 73% [11].…”

Serum Cytokine Profiling as a Diagnostic and Prognostic Tool in Ovarian Cancer: A Potential Role for Interleukin 7

“…We and others found that the commonly used tumor marker CA-125 was elevated (>35,000 units/L) in 82% of the ovarian cancer patients (2). However, as has been shown by many previously, CA-125 was also elevated in part of the patients with benign tumors and, therefore, lacks sufficient sensitivity and specificity to be used solitarily for distinguishing between malignant and benign pelvic mass (11). To our knowledge, IL-7 has never been investigated for use as a diagnostic tool in ovarian cancer.…”