We evaluated serum CA-125 levels with 251 patients in ovarian tumor. The serum CA-125 levels were measured by immunoradiometric assay before lapartotomy in 218 (86.8%) cases of benign ovarian tumor, 10(4.0%) cases of low malignant ovarian tumor
and
23(9.2%) cases of malignant ovarian tumor.
The mean concentration of preoperative serum CA -125 antigen in benign, boderline and malignant ovarian tumor were 36.6±43.5(Mean±SD)U/ml, 77.1±41.2(Mean±SD)U/ml and 568.7±700.4(Mean±SD)U/ml, respectively.
These findings suggest that elavated serum CA-125 levels help differential diagnosis of ovarian malignancy from benign and borderline ovarian tumor, but less relative differential diagnosis of boderline malignant tumor from benign ovarian tumor
(P<0.05). Among 218patients with benign ovarian tumor, CA-125 levels above 35U/ml, and 65U/ml were detected in 68(31.2%) and 23(10.5%) cases of the patients respectively.
Seven of 10 (70%) cases of boderline ovarian tumors were associated with CA-125 levels above 35U/ml and 5 of 10(50%) cases had levels that exceeded 65U/ml. Eighteen of 23(78.3%) cases of malignant ovarian tumors were associated with CA-125 levels
above
35U/ml and 14 of 23(60.9%) cases had levels that exceeded 65U/ml.
In 251 patients with benign, boderline and malignant ovarian tumors, the positive rates of preoperative serum CA-125 levels were 75.8% sensitivity, 68.8% specificity, 35.5%positive predictive valus, 94.4% negative predictive value, and 69.7%
diagnostic
efficiency for a 35U/ml cut-off and 57.6%, 89.5%, 78.6%, 93.3% and 85.3% resectively for a 65U/ml cut-off.
This serum CA-125 levels seem to provide less information for early diagnosis of both boderline malignant and malignant ovarian tumors due to highly false negativity of early stage in boderline malignant and malignant ovarian tumor. The mean
concentration of preoperative serum CA 125 antigen of stage I, II, III, IV in malignant ovarian tumor were 42.2±23.9(Mean±SD)U/ml, 67.3±36.5(Mean±SD)U/ml, 345.0±231.5(Mean±SD)U/ml and 2136.4±1255.3 (Mean±SD), respectively.
Preoperative CA-125 level have good correlation with clinical stage of ovarian maligancy. Accurate diagnosis of the malignant ovarian tumors may be difficult because endometriosis (58.9±33.5u/ml) and other benign ovarina tumors showed high
concentrations and false positive rate.
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