title: Evaluation of Preoperative Serum Levels of CA 125 and Expression of p53 in Ovarian Neoplasms: A Prospective Clinicopathological Study in a Tertiary Care Hospital.
abstract: OBJECTIVE
  To assess the preoperative serum levels of CA 125 with its diagnostic role and to evaluate the p53 expression in patients of primary ovarian neoplasms. We also wished to judge their relationship with other parameters like clinical staging and histopathologic tumor type.
  
  
  METHODS
  The present study was conducted on 86 patients during the study period of 2.5 years. Preoperative CA 125 levels were evaluated by an automated immunoassay analyzer. p53 expression was judged immunohistochemically with pre-diluted monoclonal antibody. An objective scoring was done depending on distinct nuclear immunopositivity.
  
  
  RESULTS
  Median value of preoperative CA 125 levels was 32 U/mL in benign surface epithelial-stromal tumors (BSEST), 53 U/mL in borderline surface epithelial-stromal tumors (BOT), 346 U/mL in malignant surface epithelial-stromal tumors (MSEST) and 560 U/mL in serous adenocarcinomas (SAC). Most of ovarian tumors were in the FIGO stage I (64 cases, 74.4%), but higher stages (II, III, IV) were observed mostly in MSESTs. SACs displayed the maximum p53 expression. Considering the cut-off value of more than 35 U/mL in CA 125 levels, the sensitivity to diagnose MSESTs was 94.7%. Preoperative CA 125 levels strongly and positively correlated with FIGO staging and p53 expression. Similarly p53 expression strongly and positively correlated with FIGO staging and histopathological categories.
  
  
  CONCLUSIONS
  Higher values of preoperative CA 125 levels and higher expression p53 are associated with MSESTs and BOTs especially of serous type. They strongly correlate with each other and with tumor stage. But there is no serum CA 125 concentration that can clearly differentiate benign and malignant ovarian masses.
authors.affiliation: Department of Pathology, Institute of Post Graduate Medical Education and Research, Kolkata, India.
authors.forename: Ranjan Kumar
authors.initials: RK
authors.lastname: Tiwari
authors.affiliation: Department of Pathology, Murshidabad Medical College and Hospital, Berhampore, Murshidabad, India ; 42/9/2, Sashi Bhusan Neogi Garden Lane Baranagar, Kolkata, 700 036 India.
authors.forename: Kaushik
authors.initials: K
authors.lastname: Saha
authors.affiliation: Department of Pathology, Bankura Sammilani Medical College and Hospital, Bankura, India.
authors.forename: Debasis
authors.initials: D
authors.lastname: Mukhopadhyay
authors.affiliation: Department of Pathology, Institute of Post Graduate Medical Education and Research, Kolkata, India.
authors.forename: Chhanda
authors.initials: C
authors.lastname: Datta
authors.affiliation: Department of Pathology, Institute of Post Graduate Medical Education and Research, Kolkata, India.
authors.forename: Uttara
authors.initials: U
authors.lastname: Chatterjee
authors.affiliation: Department of Obstetrics and Gynecology, Institute of Post Graduate Medical Education and Research, Kolkata, India.
authors.forename: Tarun Kumar
authors.initials: TK
authors.lastname: Ghosh
keywords: CA 125; Epithelial ovarian cancer; Immunohistochemistry; Ovary; p53