Serum CA125 level before the development of ovarian cancer.
BACKGROUND
Little is known about the natural history of ovarian cancer with respect to the change of serum CA125 level.


METHODS
The Shizuoka Cohort Study on Ovarian Cancer Screening (SCSOCS) Trial contains approximately 100,000 data on serum tumor marker CA125 prospectively obtained from more than 70,000 women. We reviewed the clinical charts and collected serum samples 2 months to 9.4 years prior to the surgery were available.


RESULTS
In 396 (95%) of the 419 patients with ovarian cancer, one serum sample was present before the diagnosis (mean, 4.1 years). The change of CA125 level before the diagnosis of ovarian cancer could be clearly separated into two groups according to the length of the following intervals: 47% (107/228) of patients with non-serous-type ovarian cancers develop secondarily from slightly elevated CA125 level (35 <CA125 <65 U/ml), with a mean interval of 3.8 years. On the other hand, 75% (126/168) of patients with serous-type ovarian cancer seem to develop suddenly from a normal CA125 level (CA125 <35 U/ml), with a mean interval of 1.4 years (p=0.011).


CONCLUSIONS
The slightly elevated CA125 level is typically present many years before the diagnosis especially in patients with non-serous-type ovarian cancer. However, serous-type ovarian cancer may exhibit a rapid progression possibly through de novo carcinogenesis.
Kobayashi
H
H
Department of Obstetrics and Gynecology, Nara Medical University, Shijo-cho, Kashihara, Nara, Japan. hirokoba@naramed-u.ac.jp
Ooi
H
H
Yamada
Y
Y
Sakata
M
M
Kawaguchi
R
R
Kanayama
S
S
Sumimoto
K
K
Terao
T
T
D000368:Aged; D000369:Aged, 80 and over; D018394:CA-125 Antigen / Q000097:blood*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000097:blood* / Q000000981:diagnostic imaging; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013997:Time Factors; D014463:Ultrasonography
D018394:CA-125 Antigen