title: Stage IA ovarian cancers: comparison of sonographic findings and histopathologic types between patients with normal and elevated serum cancer antigen 125 levels.
abstract: OBJECTIVE
  The purpose of this study was to compare sonographic findings and histopathologic types of stage IA ovarian cancers between groups with normal and elevated cancer antigen 125 (CA-125) levels.
  
  
  METHODS
  Between 2000 and 2009, 146 stage IA ovarian cancers were treated surgically (85 invasive and 61 borderline, 73 self-referred with tumor-related symptoms, 20 self-referred with nonspecific symptoms, 52 identified through screening, and 1 other). Of these, 87 cases (60%) had normal serum CA-125 levels (<35 U/mL). Their pre-operative sonographic findings and histopathologic types were compared to those of cases with elevated CA-125 levels.
  
  
  RESULTS
  Statistically significant differences were found between the proportions of patients with elevated CA-125 levels in groups having tumors with maximal diameters of less than 20 cm and at least 20 cm (P = .03) and groups having tumors with less than 50% and 50% to 80% solid components (P = .02). In the group with normal CA-125 levels, we found predominantly mucinous adenocarcinoma in multilocular cysts with less than 50% solid components (25 cases), and clear cell adenocarcinoma in unilocular cysts with less than 50% solid components (12 cases), whereas in the group with elevated CA-125 levels, mucinous adenocarcinoma in multilocular cysts with less than 50% solid components (19 cases) and endometrioid adenocarcinoma in solid tumors (≥80% solid components) were predominant (5 cases).
  
  
  CONCLUSIONS
  Stage IA ovarian cancers with normal CA-125 levels tend to be smaller, have less solid components, and have a slightly different distribution of histopathologic types than cancers with elevated CA-125 levels.
authors.affiliation: Cancer Screening Center, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan. makiko-h@umin.ac.jp
authors.forename: Makiko
authors.initials: M
authors.lastname: Hirai
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Hirai
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Tsuchida
authors.forename: Toshio
authors.initials: T
authors.lastname: Takada
authors.forename: Haruko
authors.initials: H
authors.lastname: Iwase
authors.forename: Kuniko
authors.initials: K
authors.lastname: Utsugi
authors.forename: Yuko
authors.initials: Y
authors.lastname: Sugiyama
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Takeshima
authors.forename: Reiko
authors.initials: R
authors.lastname: Furuta
authors.forename: Ken
authors.initials: K
authors.lastname: Takizawa
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood; D018394:CA-125 Antigen / Q000097:blood*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000097:blood* / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D014463:Ultrasonography
chemical_list: D014408:Biomarkers, Tumor; D018394:CA-125 Antigen