Estradiol, gonadotropins, and tumor markers in ovarian cyst fluid.
BACKGROUND
The study was designed to improve the discrimination between functional and neoplastic ovarian cysts in order to avoid unnecessary surgery.


METHODS
Concentrations of tumor markers (CA 125, CEA, CASA, CA 72-4) and hormones (estradiol, FSH, LH) in cyst fluid were detected by enzyme immuno- or immunoradiometric assays. Wilcoxon test was used to evaluate the correlation of cyst fluid markers and histology.


RESULTS
One hundred and thirty-eight ovarian cyst aspirates were investigated. Seventy-one patients (51.5%) had functional cysts whereas 67 (48.5%) had benign (n=59) or malignant (n=8) cystic tumors. Statistically significant correlations of CA 125 (p<0.0005) and CASA (p<0.02) with neoplastic histology were found. No significant correlation could be detected between CA 72-4, CEA, or hormone values and histology. Elevated estradiol concentrations are suspicious for functional cysts in premenopausal age. Low FSH and LH levels seem to be an indicator for functional cysts in peri- and postmenopausal age.


CONCLUSIONS
The assessed analytes could not reliably distinguish between functional and neoplastic ovarian cysts. Our results indicate that CA 125 is a marker for neoplastic histology in a proportion of ovarian cysts. The use of FSH and LH in the diagnosis of postmenopausal blastomas needs further investigation.
Reimer
T
T
Department of Obstetrics, Gynecology, Faculty of Medicine, University of Rostock, Germany.
Gerber
B
B
Kunkel
S
S
Luettich
K
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015295:Antigens, Tumor-Associated, Carbohydrate / Q000032:analysis; D014408:Biomarkers, Tumor / Q000032:analysis*; D018394:CA-125 Antigen / Q000032:analysis; D002272:Carcinoembryonic Antigen / Q000032:analysis; D002648:Child; D002979:Climacteric; D003937:Diagnosis, Differential; D004958:Estradiol / Q000032:analysis*; D005260:Female; D005640:Follicle Stimulating Hormone / Q000032:analysis*; D006652:Histological Techniques; D006801:Humans; D007986:Luteinizing Hormone / Q000032:analysis*; D008875:Middle Aged; D010048:Ovarian Cysts / Q000737:chemistry*; D010051:Ovarian Neoplasms / Q000737:chemistry*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric
D015295:Antigens, Tumor-Associated, Carbohydrate; D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; C083825:CA-72-4 antigen; D002272:Carcinoembryonic Antigen; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone