Preoperative serum samples were collected from 78 patients with pelvic masses. Using immunoradiometric assays, tumor-associated antigens CA 125, CA 15-3, and TAG were measured to evaluate the usefulness of these markers in differentiating benign
from
malignant pelvic masses. Serum CA 125 levels were elevated above 65 U/ml in 85% of 33 patients with benign pelvi masses. Elevation of CA 15-3(>30 U/ml) and 72(>10 U/ml) levels occurred in 45% and 30% of patients with malignancies, and 9% and 4%
of
patients with benign masses, respectively. Serum CA 125 levels distinguished most effectively between patients with malignant pelvic masses and those with benign pelvic masses, having a sensitivity of 85% and a specificity of 76% at the cut-off
level of
65 U/ml. When differentiating 21 patients with epithelial ovarian cancer from 45 patients with benign masses, the CA 125 levels(> 65 U/ml) alone had a sensitivity of 95% and a specificity of 76%. Comparing to CA 125, sensitivities of CA 15-3 and
TAG 72
were much lower, 57% and 48%, respectively. However, specificities of these two markers were much higher than CA 125, 91% and 96%, respectively. Coordinate elevations of CA 125(>65 U/ml) and CA 15-3(>30 U/ml) or TAG 72(>10 U/ml) discriminated
epithelial
cancers from benign masses with a sensitivity of 62% and specificity of 98%. Among patients over 50 years of age, a sensitivity and a specificity increases to 79% and 100%, respectively. Consequently, combine4d use of CA 15-3 and TAG 72 with CA
125
can
obtain an acceptable sensitivity and an excellent specificity in differentiating malignant from benign pelvic masses, particularly among patients over 50 years of age. Prospective studies will be required to examine the efficacy of combined use
of
additional markers with CA 125 in the screening of ovarian cancer.
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