Serum CA 125, carcinoembryonic antigen, and CA 19-9 as tumor markers in borderline ovarian tumors.

OBJECTIVES The goals of this study were to analyze preoperative serum levels of CA 125, carcinoembryonic antigen (CEA), and CA 19-9 in patients with borderline ovarian tumors and to investigate if routine assessment of these markers in follow-up may lead to earlier detection of recurrence. METHODS For patient identification a database was used, in which data from all patients treated for gynecologic malignancies in the Department of Gynecologic Oncology, University Hospital Groningen, The Netherlands, are compiled. Between 1982 and 1997, 44 patients with borderline ovarian tumors were identified. Clinical data and serum CA-125 and CEA levels were retrieved from the database. CA 19-9 levels were determined in retrospect in available stored preoperative (24 patients) and follow-up (43 patients) serum samples. RESULTS Preoperative CA 125 levels were elevated in 8 of 33 (24%), CEA levels in 3 of 32 (9%), and CA 19-9 levels in 11 of 24 (46%) cases. In patients with mucinous tumors preoperative CA 19-9 was more frequently elevated (8/14, 57%) than CA 125 (3/20, 15%) (P = 0.02) or CEA (2/18, 11%) (P = 0.02). Complete follow-up serum CA 125, CEA, and CA 19-9 levels were available for 43 of 44 patients. Median follow-up was 84 months (range, 22-204). During follow-up two patients (5%) had recurrent disease. In one patient CA 125 became elevated at the time of recurrence; in the other patient (in retrospect) the CA 19-9 level did not return to normal after surgery, but kept rising, preceding clinical symptoms of recurrence for 13 months. CONCLUSIONS If one chooses to use serum markers in follow-up of mucinous borderline ovarian tumors CA 19-9 should be included. Measurement of serum tumor markers in the follow-up of patients with borderline ovarian tumors may lead to earlier detection of recurrence in only a very small proportion of patients, while the clinical value of earlier detection of recurrence remains to be established.

[1]  P. V. van Diest,et al.  Tracing the origin of adenocarcinomas with unknown primary using immunohistochemistry: differential diagnosis between colonic and ovarian carcinomas as primary sites. , 1998, Human pathology.

[2]  H. D. de Bruijn,et al.  The value of cancer antigen 125 (CA 125) during treatment and follow-up of patients with ovarian cancer. , 1997, Current opinion in obstetrics & gynecology.

[3]  F. Kikkawa,et al.  Clinical value of CA125, CA19-9, CEA, CA72-4, and TPA in borderline ovarian tumor. , 1996, Gynecologic oncology.

[4]  C. Tropé,et al.  Prognosis and management of borderline tumours of the ovary. , 1996, Current opinion in obstetrics & gynecology.

[5]  S. Silverberg,et al.  Ovarian mucinous tumors of low malignant potential: a clinicopathologic study of 54 tumors of intestinal and müllerian type. , 1995, International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists.

[6]  E. Trimble,et al.  Management of epithelial ovarian tumors of low malignant potential. , 1994, Gynecologic oncology.

[7]  P. Kenemans,et al.  CA 125 in gynecological pathology--a review. , 1993, European journal of obstetrics, gynecology, and reproductive biology.

[8]  G. Mariani,et al.  The concomitant determination of different tumor markers in patients with epithelial ovarian cancer and benign ovarian masses: Relevance for differential diagnosis , 1992 .

[9]  S. Takeuchi,et al.  Cancer antigen 125, carcinoembryonic antigen, and carbohydrate determinant 19‐9 in ovarian tumors , 1990, Cancer.

[10]  Aimo Ojala.  Studies on Bilirubin in Amniotic Fluid: With Special Reference to Liver Function Tests , 1971, Acta obstetricia et gynecologica Scandinavica. Supplement.

[11]  H. D. de Bruijn,et al.  Cancer-associated antigen CA 195 in patients with mucinous ovarian tumours: a comparative analysis with CEA, TATI and CA 125 in serum specimens and cyst fluids. , 1993, Tumour biology : the journal of the International Society for Oncodevelopmental Biology and Medicine.

[12]  R. Molina,et al.  A prospective study of tumor markers CA 125 and CA 19.9 in patients with epithelial ovarian carcinomas. , 1992, Tumour biology : the journal of the International Society for Oncodevelopmental Biology and Medicine.