Preoperative determination of CASA (Cancer Associated Serum Antigen) and CA-125 for the discrimination between benign and malignant pelvic tumor mass: a prospective study.
BACKGROUND
CA-125 is the most important tumor marker in epithelial ovarian cancer. Due to its low specificity, a combination with CASA may improve the clinical discrimination between benign and malignant adnexal masses.


METHODS
In a prospective study CA-125 and CASA were analyzed in blood specimens of 153 patients, including 29 ovarian cancer.


RESULTS
The median levels of both markers were significantly higher in ovarian cancer than in benign diseases. The sensitivity of CA-125 was 90%, while the specificity was 79%. PPV and NPV were 50% and 97%. In comparison, the sensitivity of CASA was lower (38%), while the specificity was slightly higher (86%). PPV and NPV were 39% and 86%. When both markers were used together, the specificity could be increased to 96% but the sensitivity remained at only 38%. The PPV and NPV was 69% and 87%.


CONCLUSIONS
The combination of CA-125 and CASA can improve the detection of patients with suspected ovarian cancer.
Sehouli
Jalid
J
Charité, Department of Obstetrics and Gynaecology, Humboldt University, Augustenburger Platz 1, D-13353 Berlin, Germany. sehouli@aol.com
Akdogan
Zera
Z
Heinze
Thomas
T
Könsgen
Dominique
D
Stengel
Dirk
D
Mustea
Alexander
A
Lichtenegger
Werner
W
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000951:Antigens, Neoplasm / Q000097:blood*; D014408:Biomarkers, Tumor / Q000097:blood*; D018394:CA-125 Antigen / Q000097:blood; D003937:Diagnosis, Differential; D005260:Female; D005831:Genital Diseases, Female / Q000097:blood / Q000601:surgery*; D005833:Genital Neoplasms, Female / Q000097:blood / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000601:surgery; D010386:Pelvic Neoplasms / Q000097:blood / Q000601:surgery*; D011184:Postoperative Period; D011446:Prospective Studies
D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; C121307:CASA antigen