CA125 in ovarian cancer: European Group on Tumor Markers guidelines for clinical use

Abstract

CA125 is currently the most widely used tumor marker for ovarian epithelial cancer. The aim of this article is to provide guidelines for the routine clinical use of CA125 in patients with ovarian cancer. Due to lack of sensitivity for stage I disease and lack of specificity, CA125 is of little value in the detection of early ovarian cancer. At present, therefore, CA125, either alone or in combination with other modalities, cannot be recommended for screening for ovarian cancer in asymptomatic women outside the context of a randomized controlled trial. Preoperative levels in postmenopausal women, however, may aid the differentiation of benign and malignant pelvic masses. Serial levels during chemotherapy for ovarian cancer are useful for assessing response to treatment. Although serial monitoring following initial chemotherapy can lead to the early detection of recurrent disease, the clinical value of this lead-time is unclear. CA125 is the ovarian cancer marker against which new markers for this malignancy should be judged.

Human epididymis protein 4 (HE4) in benign and malignant diseases

“…Besides vaginal sonography, tumor marker values may aid to detect ovarian cancer in early stages. For almost 30 years, the tumor marker CA 125 was the most relevant biomarker for the management of patients with ovarian cancer (18) . However, for the purpose of primary diagnosis, in clinical practice corresponding to the differential diagnosis of pelvic masses, the use of CA 125 has its limitations.…”

Methylated genes as new cancer biomarkers

“…As well as lacking sensitivity for early stage disease, CA 125 can be increased in most types of adenocarcinomas as well as in multiple types of benign diseases, both gynaecological and non-gynaecological diseases (for review, see Ref. [63]). Similar to the situation with PSA in prostate cancer, this lack of sensitivity and specificity limits the use of CA 125 in screening asymptomatic subjects for ovarian cancer.…”

Tissue CA125 and HE4 Gene Expression Levels Offer Superior Accuracy in Discriminating Benign from Malignant Pelvic Masses

“…So far, cancer antigen 125 (CA125) is the most widely used serum biomarker for detecting and monitoring ovarian cancer in the clinical setting (Bast et al, 2005;Duffy et al, 2005;Sturgeon et al, 2008;Medeiros et al, 2009). Nevertheless, elevated serum CA125 levels are only seen in 50% of patients presented with early stage ovarian cancer and 80%-90% of patients with late stage disease, thus limiting its sensitivity (Molina et al, 1992;Rosen et al, 2005).…”