BACKGROUND: The serum marker CA125 is still the most widely used biomarker for ovarian cancer (OC) diagnosis in gynecological and oncological setting, but its predictive role in early-stage OCis still debated. The aim of this study was to explore the value of CA125 in distinguishing between early-stage OCand borderline ovarian tumor (BOT) and to evaluate the accuracy of CA125 in the detection of early stage OC. METHODS: Aretrospective cohort study was performed at the University Hospital of Bologna (Italy) on 1296 consecutive women suffering from OCor BOT (diagnosed at histology) between 1988-2017. Patients for whom CA125 level was determined preoperatively were included. The positive cut-off level used was >35 U/mL. RESULTS: Of 910 patients, 192 (21.1%) were diagnosed with BOT and 718 (78.9%) with OC. The sensitivity of CA125 for stage IOCwas 54.4 (95% CI: 45.3-63.3) (51.5 for IA, 54.6 for IB, 58.3 for IC), but it increased to 78.0 (95% CI: 63.7-88.0) for stage II. Interestingly, in stage I OC, CA 125 presented a significantly higher sensitivity for the endometrioid histotype [72.4 (95% CI: 52.5-86.5) vs. 49.0 (95% CI: 38.6-59.4), P=0.026]. The positive likelihood ratio of CA125 for early-stage OCcompared to BOT was 1.29 (95% CI: 1.06-1.58). CONCLUSIONS: Despite its limited sensitivity for early-stage OCs, CA125 still represents a useful serum marker to early differentiate between OCs and BOTs. Its sensitivity for stage IOCincreases in endometrioid histotype.
Grandi G., Perrone A.M., Toss A., Vitagliano A., Friso S., Facchinetti F., et al. (2020). The generally low sensitivity of CA125 for FIGO stage Iovarian cancer diagnosis increases for endometrioid histotype. MINERVA MEDICA, 111(2), 133-140 [10.23736/S0026-4806.20.06474-5].
The generally low sensitivity of CA125 for FIGO stage Iovarian cancer diagnosis increases for endometrioid histotype
Perrone A. M.;Friso S.;De iaco P.
2020
Abstract
BACKGROUND: The serum marker CA125 is still the most widely used biomarker for ovarian cancer (OC) diagnosis in gynecological and oncological setting, but its predictive role in early-stage OCis still debated. The aim of this study was to explore the value of CA125 in distinguishing between early-stage OCand borderline ovarian tumor (BOT) and to evaluate the accuracy of CA125 in the detection of early stage OC. METHODS: Aretrospective cohort study was performed at the University Hospital of Bologna (Italy) on 1296 consecutive women suffering from OCor BOT (diagnosed at histology) between 1988-2017. Patients for whom CA125 level was determined preoperatively were included. The positive cut-off level used was >35 U/mL. RESULTS: Of 910 patients, 192 (21.1%) were diagnosed with BOT and 718 (78.9%) with OC. The sensitivity of CA125 for stage IOCwas 54.4 (95% CI: 45.3-63.3) (51.5 for IA, 54.6 for IB, 58.3 for IC), but it increased to 78.0 (95% CI: 63.7-88.0) for stage II. Interestingly, in stage I OC, CA 125 presented a significantly higher sensitivity for the endometrioid histotype [72.4 (95% CI: 52.5-86.5) vs. 49.0 (95% CI: 38.6-59.4), P=0.026]. The positive likelihood ratio of CA125 for early-stage OCcompared to BOT was 1.29 (95% CI: 1.06-1.58). CONCLUSIONS: Despite its limited sensitivity for early-stage OCs, CA125 still represents a useful serum marker to early differentiate between OCs and BOTs. Its sensitivity for stage IOCincreases in endometrioid histotype.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.