Preoperative serum CA 125 level in the prediction of the stage of disease in endometrial carcinoma.
OBJECTIVE
To evaluate whether a preoperative serum CA-125 level in patients with endometrial carcinoma can provide additional information in determining the stage of disease, and which cutoff value is optimal in this respect.


METHODS
Retrospective chart review of 147 women with pathologically proven endometrial carcinoma who were treated between January 1999 and May 2009. The associations of preoperative CA-125 levels with the tumor stage, histologic type and grade, and the lymph node positivity were examined. To determine the values of cutoff point levels for serum tumor marker CA-125, the levels of 20 IU/ml and 35 IU/ml were compared.


RESULTS
High CA-125 levels significantly correlated with advanced stage and lymph node metastases. The ROC curve determined that the best cutoff value was 20 U/ml. The sensitivity and specificity of a CA-125 cutoff level of 20 U/ml were 75% and 69.51%, respectively, with a positive predictive value of 80.6% and negative predictive value of 84.9%.


CONCLUSIONS
The current study suggests that measurement of preoperative CA-125 is a clinically useful test in endometrial carcinoma patients. CA-125 appears to be a significant independent predictor of the advanced stage of the disease as well as lymph node metastases. The results complement a growing body of literature that supports the relationship between CA-125 level and stage of disease but more studies are needed to establish the appropriate cutoff level for serum CA-125 in this respect.
Department of Obstetrics and Gynecology Clinic III, Izmir Ataturk Training and Research Hospital, Izmir, Turkey.
Askin
A
Yildiz
Hakan
H
Yetimalar
Burcu
B
Kasap
Cetin
C
Aydin
Sumeyra
S
Tatar
Ferit
F
Soylu
Fatma Sebnem
FS
Yildiz
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018394:CA-125 Antigen / Q000097:blood*; D002277:Carcinoma / Q000097:blood* / Q000473:pathology* / Q000556:secondary / Q000601:surgery; D016889:Endometrial Neoplasms / Q000097:blood* / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000175:diagnosis* / Q000473:pathology; D008499:Medical Records; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D057234:Preoperative Period; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
D018394:CA-125 Antigen