The preoperative serum CA125 can predict the lymph node metastasis in endometrioid-type endometrial cancer

Abstract

Objectives: To evaluate the predictive value of preoperative CA125 in extra-uterine disease and its association with poor prognostic factors in endometrioid-type endometrial cancer (EC). Material and methods: A total of 423 patients with pathologically proven endometrioid-type EC were included in the study. The association between preoperative CA125 level and surgical-pathological factors was evaluated. The conventional cutoff value was defined as 35 IU/mL. Results: A high CA125 level (> 35 IU/mL) was significantly associated with all of the studied poor prognostic factors, except grade. The risk of lymph node metastasis (LNM) increased from 15.9% to 45.7% when CA125 level was > 35 IU/mL (p < 0.05). The optimal cutoff value for the prediction of LNM in patients aged > 50 years was determined to be 16 IU/mL (sensitivity, specificity, positive predictive value, and negative predictive value were 71%, 60%, 35%, and 87%, respectively.) Conclusions: Preoperative CA125 level was significantly related with the extent of the disease and LNM. The age-dependent cutoff level of CA125 can improve the prediction of LNM in endometrioid-type EC. For older patients, CA125 level of > 16 IU/ml could be used to predict LNM. However, further studies are needed to evaluate the appropriate cutoff level of CA125 for younger patients.

Can preoperative magnetic resonance imaging replace intraoperative frozen sectioning in the evaluation of myometrial invasion for early-stage endometrial carcinoma?

“…Elevated CA 125 levels are correlated with increasing depth of myometrial invasion [20]. The median CA 125 level was higher in the deep myometrial invasion group, consistent with previous studies [20,21].…”

Malignant Transformation and Associated Biomarkers of Ovarian Endometriosis: A Narrative Review

“…However, this level is disputable and cannot ideally correspond to all CA125 values. For example, in postmenopausal women or in patients after a hysterectomy, CA125 level tends to decrease compared to the general population (20 and 26 IU/ml) [ 61 ]. In general, about 85% of patients with ovarian epithelial tumors have CA125 levels higher than 35 IU/ml.…”

“…In general, about 85% of patients with ovarian epithelial tumors have CA125 levels higher than 35 IU/ml. Levels above 35 IU/ml were found in 50% of patients with stage I ovarian tumor while higher serum CA125 levels were found in more than 90% of women at more advanced stages [ 60 , 61 ]. CA125 rises in mucinous, clear cell, and borderline tumors less often than in malignant ones.…”

The Prognostic Value of Preoperative Serum CA125 in Endometrioid Endometrial Cancer with Cervical Stromal and Parametrial Invasion

“…research by Nillof et al about elevated levels of CA125 in advanced endometrial cancer (4), the interest in evaluating the correlation of this tumor marker with other surgicopathologic and prognostic variables of this cancer increased. Several studies evaluated the correlation of preoperative CA125 in endometrial cancer with depth of myometrial invasion (5), cervical involvement (5-7), stage (6,8,9), grade (10), lymphovascular invasion (8), extrauterine and adnexal involvement (6,7,9,11) as well as lymph node metastasis (8)(9)(10)(12)(13)(14). Some studies evaluated the utility of serum CA125 for follow-up of patients with endometrial cancer in order to detect disease recurrence (5).…”

“…Some studies evaluated the utility of serum CA125 for follow-up of patients with endometrial cancer in order to detect disease recurrence (5). Some experts have recommended preoperative assessment of CA125 for determining the need for lymphadenectomy in endometrial cancer, which has been a matter of controversy long before (7,8,10,(12)(13)(14).…”