title: The Value of Preoperative CA 125 Levels in Prediction of Myometrial Invasion in Patients with Early-stage Endometrioid- type Endometrial Cancer.
abstract: OBJECTIVE
  To evaluate the relationship between pre-operative CA-125 levels and myometrial invasion in patients with early-stage endometrioid-type endometrial cancer.
  
  
  METHODS
  Two-hundred and sixty patients were diagnosed with endometrial cancer between January 2007 and December 2012. Of these, 136 patients with stage 1 endometrioid histologic-type and documented pre-operative serum CA-125 levels were included in the study. Age, preoperative CA-125 level, histologic grade, surgical grade, and presence of deep myometrial invasion were recorded. Additionally, 16, 20, and 35 IU/ml cutoff values were used and compared to evaluate the relationship between pre-operative CA-125 levels and myometrial invasion.
  
  
  RESULTS
  The average serum CA-125 level was 35.4±36.7 in patients with deep myometrial invasion, and 21.5±35.8 in cases without deep myometrial invasion. The relationship between the presence of deep myometrial invasion and CA-125 cut-off values (16, 20, 35 IU/ml) was statistically significant, although the correlation was weak (p<0.05). When the relationship between 16, 20 and 35 IU/ml CA-125 cut-off values and the presence of deep myometrial invasion was studied, specifity and sensitivity values were identified as: 0.60-0.68 for 16 IU/ml; 0.73-0.48 for 20 IU/ml; and 0.89-0.33 for 35 IU/ml. The sensitivity of 16 IU/ml cut-off value was higher when compared to other values.
  
  
  CONCLUSIONS
  This study demonstrates that preoperative serum CA-125 values maybe used as a predictive test in patients with early stage endometrioid-type endometrium cancer, and as a prognostic factor alone. Further studies should be conducted to identify different CA-125 cut-off values in patients with low risk endometrial cancer.
authors.affiliation: Gynecology and Obstetrics Department, Akropol Medical Hospital, Ankara, Turkey E-mail : serenateris@hotmail.com.
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Atguden
authors.forename: Askin
authors.initials: A
authors.lastname: Yildiz
authors.forename: Hayri
authors.initials: H
authors.lastname: Aksut
authors.forename: Serenat Eris
authors.initials: SE
authors.lastname: Yalcin
authors.forename: Yakup
authors.initials: Y
authors.lastname: Yalcin
authors.forename: Dilek
authors.initials: D
authors.lastname: Uysal
authors.forename: Hakan
authors.initials: H
authors.lastname: Yetimalar
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D018394:CA-125 Antigen / Q000097:blood*; D018269:Carcinoma, Endometrioid / Q000097:blood / Q000473:pathology* / Q000601:surgery; D016889:Endometrial Neoplasms / Q000097:blood / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009215:Myometrium / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011300:Preoperative Care; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies
chemical_list: D014408:Biomarkers, Tumor; D018394:CA-125 Antigen