Pre-operative discrimination between benign and malignant ovarian tumors using a combination of CA125 and CA15.3 serum assays

Abstract

Serum levels of CAI25 and CA15.3 were measured in 70 patients presenting with an ovarian neoplasm, of whom 38 had an ovarian malignancy and 32 a benign ovarian tumor. CAI25 levels exceeded 35 Ulml in 71 O h of ovarian carcinomas and in 25% of benign ovarian tumors. In the entire group of 70 patients, CAI25 levels (> 35 U/ml) were elevated in 35 patients, of whom 27 had ovarian cancer. CA15.3 levels were found t o be elevated (> 30 U/ml) in 9% of benign ovarian tumors and in 50°h of ovarian malignancies. Of 8 patients with a false positive CAI25 (> 35) elevation, only one had an elevated CA15.3 level whereas in 27 correct positive patients 19 also had elevated CA15.3 levels. Of all 20 patients with both markers elevated, I 9 patients (95%) had ovarian cancer. When a cut-off level of 65 U/ml was used for the tumor marker CA125, all patients with simultaneous elevation of both markers were found to have an ovarian malignancy. Using a panel of CAI25 (> 35 U/ml) and CA15.3 (> 30 U/ml) and requiring a simultaneous marker elevation, the sensitivity of the test decreased from 71% to 50% but the corresponding specificity of the test rose from 75% t o 97%. Specificity was as high as 100% if in the same panel of tests a 65 U/ml cut-off for CAI25 was taken. A comparison of early stage 1-11 ovarian cancer with benign ovarian tumors failed to demonstrate a discriminatory capacity of any test or test combination. We conclude that the use of a panel of tumor markers is advantageous in the pre-operative discrimination of benign and malignant ovarian tumors, since the predictive value for malignancy of a combined marker elevation was as high as 100% in the population studied.

Clinical and technical evaluation of the ACS:OV serum assay and comparison with three other CA125-detecting assays

“…20 This diagnostic power is also evident from the area under the ROC curve (0.906+0.017) presented in Fig. 4, which is not signi¢cantly di¡erent from those found with the Centocor CA125 II assay (0.908+0.017) and Roche Enzymun-Test CA125 II (0.903+0.017).…”

Antibody-dependent cell-mediated cytotoxicity can be induced by MUC1 peptide vaccination of breast cancer patients

“…3 In the vast majority of human adenocarcinomas this protein is over-expressed and hypo-glycosylated 4 exposing an immunodominant repetitive amino acid sequence. The overproduction and secretion of MUC1 is correlated with the progression of breast, 5 ovarian 6,7 and colon 8 carcinoma. In breast cancer patients MUC1 serum levels are used to monitor therapy and for early detection of recurrences.…”

Serum Markers CASA and CA15-3 in Ovarian Cancer: All MUC1 Assays Are Not the Same

“…Assays for the M UC1 mucin (CA 15-3 and the cancer-associated serum antigen or CASA) have been proposed to be useful adjuncts for C A 125 [4][5][6][7][8][9][10][11], In combination with C A 125, C A SA gave elevated levels in 69% of patients with ovarian cancer using cutpoints which excluded benign disease [4], In addition, the combination of these assays improved the management of patients during their course of therapy, with recurrence detected in 80% of 20 patients before clinical symptoms were ap parent [6]. The combined use of C A 125 and C A 15-3 has also been shown to improve pre operative discrimination between benign and malignant ovarian tumours [9][10][11]. In addi tion, C A 15-3 showed a good correlation with response to chemotherapy in patients with ovarian cancer [12], Since CA SA and C A 15-3 utilise monoclonal antibodies (MAbs) which react with epitopes on the M U C 1 mucin (DF3 and 115D8 for C A 15-3; BC2 and BC3 for CASA) [13][14][15][16][17][18], we have compared these as says in the serum of patients with ovarian can cer and in pregnant women.…”