Plasma D-dimer and peritoneal CA-125 levels as predictors of disease status in ovarian carcinoma.
Although serum CA-125 has improved our ability to monitor tumor response in ovarian carcinoma, approximately 50% of patients with normalization of CA-125 have persistent disease at second look laparotomy. Peritoneal CA-125 and plasma D-Dimer levels were studied to determine if their use could increase the sensitivity for persistent ovarian carcinoma in a population of patients with normal physical examinations, radiologic studies, and serum CA-125 values. Plasma D-Dimer levels were obtained prior to second look laparotomy. The results of peritoneal CA-125 and plasma D-Dimer studies were compared to second look laparotomy results. Differences were evaluated with a one-way analysis of variance. Twenty-seven patients were studied. Peritoneal CA-125 was evaluated in 23 patients and ranged from < 6.3-223 U/ml. There was no statistical difference in peritoneal CA-125 levels between patients whose second look laparotomies were negative, or microscopically or macroscopically positive. D-Dimer was elevated in three patients, all of whom had macroscopically positive second look findings. The sensitivity for positive second look findings was only 27%. Minimally elevated plasma D-Dimer levels were specific but not sensitive for persistent disease and peritoneal CA-125 was not predictive of disease status.
Department of Obstetrics and Gynecology, University of Massachusetts Medical School, Worcester.
P G
PG
Rose
J M
JM
Terrien
S
S
Baker
D015295:Antigens, Tumor-Associated, Carbohydrate / Q000032:analysis*; D014408:Biomarkers, Tumor / Q000032:analysis*; D002277:Carcinoma / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D006801:Humans; D007813:Laparotomy; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D010533:Peritoneal Lavage; D011237:Predictive Value of Tests; D012086:Reoperation; D012680:Sensitivity and Specificity
D015295:Antigens, Tumor-Associated, Carbohydrate; D014408:Biomarkers, Tumor; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D