Obstet Gynecol Sci.  2018 May;61(3):344-351. 10.5468/ogs.2018.61.3.344.

Preoperative serum levels of cancer antigen 125 and carcinoembryonic antigen ratio can improve differentiation between mucinous ovarian carcinoma and other epithelial ovarian carcinomas

Affiliations
  • 1Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. CHAYDB@yuhs.ac

Abstract


OBJECTIVE
The main aim of this study was to evaluate cancer antigen 125 (CA125)/carcinoembryonic antigen (CEA) ratio (CCR), as a reliable marker to differentiate ovarian mucinous carcinoma from other epithelial ovarian carcinomas (EOCs), namely serous, clear cell, and endometrioid carcinomas.
METHODS
Female patients suffering from different kinds of EOCs whom were subjected to elective surgery at the Gangnam Severance Hospital between January 2008 and December 2016, were included in this study. The serum levels of CA125 and CEA were assayed using commercially available kits per the manufacturer's instructions.
RESULTS
The CCR in mucinous carcinoma (mean 32.1) was significantly lower than that of clear cell (mean 235.0) and endometrioid carcinoma (mean 427.0) in stage I (all P < 0.05). In stage II-IV, CCR in mucinous carcinoma (mean 37.6) was significantly lower than that of serous carcinoma (mean 148.0) (P < 0.01). The sensitivity and specificity of CCR in detecting mucinous carcinoma from other types of EOC was 75.0% and 77.5%, respectively in stage I and 100.0% and 84.4%, respectively in stage II-IV (both cut-off value < 90.7).
CONCLUSION
The present results suggest that pretreatment CCR might provide higher specificity and clinically relevant information as a criterion for the differentiation between ovarian mucinous carcinoma and other types of EOC.

Keyword

CA125/CEA ratio; Epithelial ovarian carcinoma; Mucinous ovarian carcinoma

MeSH Terms

Adenocarcinoma, Mucinous
Carcinoembryonic Antigen*
Carcinoma, Endometrioid
Female
Humans
Mucins*
Sensitivity and Specificity
Carcinoembryonic Antigen
Mucins

Figure

  • Fig. 1 Serum cancer antigen 125 (CA125), carcinoembryonic antigen (CEA), and CA125/CEA ratio (CCR) levels in patients with mucinous, serous, clear cell, and endometrioid ovarian carcinoma. Values for (A) CA125, (B) CEA, and (C) CCR for stage I (left panel) and stages II–IV (right panel) are shown. Significant values between the groups are presented as shown. Values were considered significant when P<0.05.

  • Fig. 2 Receiver operating characteristics (ROC) curve for preoperative cancer antigen 125 (CA125), carcinoembryonic antigen (CEA), and CA125/CEA ratio (CCR) in ovarian mucinous carcinoma vs. in other types of epithelial ovarian carcinoma. ROC curve with area under the curve (AUC) values for (A) CA125, (B) CEA and (C) CCR for stage I (left panel) and stages II–IV (right panel) are shown.


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