Prognostic value of CA 125 in ovarian cyst fluid of patients with epithelial ovarian cancer

Abstract

Abstract. Most ovarian tumors contain ovarian cyst fluid (oCF) which can be easily obtained during surgery. This is the first study that explored if CA 125 in oCF could be of prognostic value for patients with epithelial ovarian cancer (EOC). Of 54 patients with primary EOC, oCF and preoperative serum were collected and clinicopathological data were retrospectively obtained. CA 125 was measured with the commercially available CA 125 assay. CA 125 in oCF (n=54, median: 55,500 U/ml, range: 590-10,200,000 U/ml) was always higher than in the corresponding serum (n=51, median: 179 U/ml, range: 13-11,000 U/ml) (p<0.001) and values were moderately correlated (R=0.337, p=0.016). CA 125 in oCF was associated with histology (p<0.001) and tumor grade (p=0.038). High levels of oCF CA 125 (>median) were significantly associated with a poor diseasefree survival (DFS) (log-rank p=0.002 and p=0.005 univariate Cox-regression). Other factors associated with a poor DFS in univariate analysis were advanced FIGO stage, suboptimal debulking (both p<0.001), high tumor grade (p=0.025), serous histology (p=0.003) and high serum (>media) CA 125 (p=0.009). In multivariate analysis, only FIGO stage was of independent predictive value. These findings indicate that, although high levels of oCF CA 125 were significantly associated with a poor survival of EOC patients, CA 125 in oCF was not of independent predictive value and might therefore not be useful as a prognostic biomarker for EOC.

Proteome profiling of low grade serous ovarian cancer

“…Many researchers have considered using CA-125 as a biomarker for early diagnosis [13, 14]. However, CA-125 is most of the times falsely negative infertile women with serous ovarian cancer and in Low grade serous ovarian cancer and CA-125 is positive in benign diseases.…”

CA 125 in biological fluids

“…However, the conclusion was that the cyst fluid CA 125 cannot be used as a prognostic biomarker because only FIGO stage proved to have an independent predictive value in multivariate analysis. The study showed that the concentration of ovarian cyst fluid CA 125 in patients with mucinous tumors was significantly lower than in patients presenting with other histological types (p<0.001) and the CA 125 cyst fluid levels in patients with well-differentiated tumors was significantly lower than in patients presenting with poorly-differentiated tumors (p=0.038) (17).…”

Poorer prognosis of ovarian squamous cell carcinoma than serous carcinoma: a propensity score matching analysis based on the SEER database

“…Interestingly, the two large-scale reviews [7,8] demonstrated CA125 as a prognostic factor for MCT-SCC in univariate model, but did not examine its efficacy in Cox regression model. For other ovarian cancers, it has been indicated that CA125 was a valuable predictor in univariate model but lost its significance when FIGO stage was considered in multivariate model [24,25]. So it is still controversial whether preoperative serum CA125 is an independent predictor for ovarian SCC outcome.…”