Pretreatment serum levels of CA-125, carcinoembryonic antigen, tissue polypeptide antigen, and placental alkaline phosphatase, in patients with ovarian carcinoma, borderline tumors, or benign adnexal masses: relevance for differential diagnosis.
Pretreatment serum levels of the antigens CA-125, tissue polypeptide Antigen (TPA), carcinoembryonic antigen (CEA), and placental alkaline phosphatase (PLAP) were determined in samples from 295 women with adnexal masses. At laparotomy 48% of patients had epithelial ovarian carcinoma, 9% had tumors of low malignant potential, and 8% suffered from malignancies of other kinds. The sensitivity of CA-125 with 35 U/ml as the cutoff was 88% in women with ovarian carcinoma, but 74% among those with limited disease and 58% in borderline malignancy. Only 6 of 17 mucinous ovarian carcinomas were detected. Specificity was 83%. CEA was elevated above 5.0 micrograms/liter in 15 of 17 patients with mucinous ovarian cancer. TPA detected advanced stages of malignancy, but the sensitivity was low, 53%, in cases with limited disease. PLAP was elevated in 46% of ovarian carcinoma patients. For detecting malignancy overall, the use of a parallel combination of the CA-125 and CEA assays was more sensitive than use of CA-125 as a single marker. This test combination may be of value in the diagnosis of adnexal masses. The predictive value of a positive result was 90%, and that of a negative result, 76%.
Tholander
B
B
Department of Gynecologic Oncology, Uppsala University Hospital, Sweden.
Taube
A
A
Lindgren
A
A
Sjöberg
O
O
Stendahl
U
U
Kiviranta
A
A
Hallman
K
K
Holm
L
L
Weiner
E
E
Tamsen
L
L
D000291:Adnexal Diseases / Q000175:diagnosis / Q000276:immunology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000469:Alkaline Phosphatase / Q000032:analysis*; D015295:Antigens, Tumor-Associated, Carbohydrate / Q000032:analysis*; D014408:Biomarkers, Tumor / Q000032:analysis*; D002272:Carcinoembryonic Antigen / Q000032:analysis*; D002277:Carcinoma / Q000175:diagnosis / Q000276:immunology; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D058851:GPI-Linked Proteins; D006801:Humans; D007527:Isoenzymes / Q000032:analysis*; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000276:immunology; D010455:Peptides / Q000032:analysis*; D010920:Placenta / Q000201:enzymology*; D019396:Tissue Polypeptide Antigen
D015295:Antigens, Tumor-Associated, Carbohydrate; D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D058851:GPI-Linked Proteins; D007527:Isoenzymes; D010455:Peptides; D019396:Tissue Polypeptide Antigen; D000469:Alkaline Phosphatase; C019839:alkaline phosphatase, placental