Use of Serum Tumor Markers in the Differential Diagnosis between Ovarian and Colorectal Adenocarcinomas

Abstract

In the search for a method to facilitate the preoperative discrimination of ovarian carcinomas from colorectal carcinomas serum levels of 6 tumor markers were measured in 47 patients presenting with ovarian cancer and compared to levels found in 24 female patients with advanced, untreated colorectal cancer. The markers studied were CA 125, CA 15.3, CA 19.9, CEA and two recently developed mucin markers, CA M29 and CA M26. Levels of CA 125, CA 15.3, CEA and CA M29 showed significant differences between both groups. In predicting ovarian cancer, sensitivity was highest for CA 125 at 94% (35 U/ml cutoff level). However, the specificity of CA 125 was at 71% low. Specificity increased significantly by using a combination of a CA 125-positive score ( > 35 U/ml) and a simultaneous negative CEA score (≤ 5 ng/ml) (specificity 100%, sensitivity 81 %). A CA 125/CEA serum ratio > 25 resulted in the highest discriminative power with a specificity of 100% and a sensitivity of 91 % resulting in an overall test accuracy of 94%. It is concluded that the serum tumor markers used, especially a combination of CA 125 and CEA, are helpful in the preoperative differential diagnosis between adenocarcinomas of ovarian and colorectal origin.

Clinicopathological Characteristics and Prognostic Factors in Ovarian Metastases from Right- and Left-Sided Colorectal Cancer

“…One of such investigations was a preoperative serum CA 125/CEA ratio with a cut-off value of 25 [32]. In our study, 87% of the patients with known CA 125 and CEA levels had a CA 125/CEA ratio lower than 25, thus supporting the use of this ratio as an auxiliary diagnostic tool.…”

Clinicopathological Characteristics and Prognostic Factors in Ovarian Metastases from Right- and Left-Sided Colorectal Cancer

“…One of such investigations was a preoperative serum CA 125/CEA ratio with a cut-off value of 25 [32]. In our study, 87% of the patients with known CA 125 and CEA levels had a CA 125/CEA ratio lower than 25, thus supporting the use of this ratio as an auxiliary diagnostic tool.…”

Role of CA125/CEA ratio and ultrasound parameters in identifying metastases to the ovaries in patients with multilocular and multilocular‐solid ovarian masses

“…Regarding ovarian tumor marker assessment, other studies investigated the discriminating role of the CA125/CEA ratio 16,17 ; however, these studies considered different series, analyzing only primary malignant ovarian neoplasms vs ovarian metastases, and they found a higher optimal cut-off level (CA125/CEA > 25) than in the current study.…”

Little Clinical Relevance of Ca125, Cea and Ca125/Cea Ratio for the Differential Diagnosis of Ovarian and Non- Ovarian Carcinomatosis

“…Some studies talk about the utility of this serum markers and its ratio referred to the ovarian tumor but not about the relevance of them in peritoneal carcinomatosis. [12,17] In other studies, the CCR seems to be capital to diagnose non-ovarian peritoneal carcinomatosis [9][10][11]. In our series the relevance of CA 125, CEA or CCR are not as important to be diagnostic.…”

“…CCR was designed to improve the performance of tumor markers for discriminating ovarian from non-ovarian malignancies. The studies by Buamah [10] and Yedema [11] showed a good accomplishment of CCR. Moro et al tested the role of CCR to identify the metastatic showed the low ability of CCR to distinguish between primary ovarian lesions from metastatic lesions.…”

Clinicopathological Characteristics and Prognostic Factors in Ovarian Metastases from Right- and Left-Sided Colorectal Cancer

“…One of such investigations was a preoperative serum CA 125/CEA ratio with a cut-off value of 25 [32]. In our study, 87% of the patients with known CA 125 and CEA levels had a CA 125/CEA ratio lower than 25, thus supporting the use of this ratio as an auxiliary diagnostic tool.…”

Role of CA125/CEA ratio and ultrasound parameters in identifying metastases to the ovaries in patients with multilocular and multilocular‐solid ovarian masses

“…Regarding ovarian tumor marker assessment, other studies investigated the discriminating role of the CA125/CEA ratio 16,17 ; however, these studies considered different series, analyzing only primary malignant ovarian neoplasms vs ovarian metastases, and they found a higher optimal cut-off level (CA125/CEA > 25) than in the current study.…”

Little Clinical Relevance of Ca125, Cea and Ca125/Cea Ratio for the Differential Diagnosis of Ovarian and Non- Ovarian Carcinomatosis

“…Some studies talk about the utility of this serum markers and its ratio referred to the ovarian tumor but not about the relevance of them in peritoneal carcinomatosis. [12,17] In other studies, the CCR seems to be capital to diagnose non-ovarian peritoneal carcinomatosis [9][10][11]. In our series the relevance of CA 125, CEA or CCR are not as important to be diagnostic.…”

“…CCR was designed to improve the performance of tumor markers for discriminating ovarian from non-ovarian malignancies. The studies by Buamah [10] and Yedema [11] showed a good accomplishment of CCR. Moro et al tested the role of CCR to identify the metastatic showed the low ability of CCR to distinguish between primary ovarian lesions from metastatic lesions.…”

Clinicopathological Characteristics and Prognostic Factors in Ovarian Metastases from Right- and Left-Sided Colorectal Cancer

“…One of such investigations was a preoperative serum CA 125/CEA ratio with a cut-off value of 25 [32]. In our study, 87% of the patients with known CA 125 and CEA levels had a CA 125/CEA ratio lower than 25, thus supporting the use of this ratio as an auxiliary diagnostic tool.…”

Role of CA125/CEA ratio and ultrasound parameters in identifying metastases to the ovaries in patients with multilocular and multilocular‐solid ovarian masses

“…Regarding ovarian tumor marker assessment, other studies investigated the discriminating role of the CA125/CEA ratio 16,17 ; however, these studies considered different series, analyzing only primary malignant ovarian neoplasms vs ovarian metastases, and they found a higher optimal cut-off level (CA125/CEA > 25) than in the current study.…”

Little Clinical Relevance of Ca125, Cea and Ca125/Cea Ratio for the Differential Diagnosis of Ovarian and Non- Ovarian Carcinomatosis

“…Some studies talk about the utility of this serum markers and its ratio referred to the ovarian tumor but not about the relevance of them in peritoneal carcinomatosis. [12,17] In other studies, the CCR seems to be capital to diagnose non-ovarian peritoneal carcinomatosis [9][10][11]. In our series the relevance of CA 125, CEA or CCR are not as important to be diagnostic.…”

“…CCR was designed to improve the performance of tumor markers for discriminating ovarian from non-ovarian malignancies. The studies by Buamah [10] and Yedema [11] showed a good accomplishment of CCR. Moro et al tested the role of CCR to identify the metastatic showed the low ability of CCR to distinguish between primary ovarian lesions from metastatic lesions.…”