The prognostic significance of preoperative CA-125 levels in uterine
papillary serous carcinomas
Abstract
Aim: This study aimed to determine the relationship between preoperative
cancer antigen(CA) 125 levels and clinicopathologic prognostic factors
as well as appropriate cut-off levels for pure uterine papillary serous
carcinoma (UPSC). Methods: Study data were collected from the documents
and electronic medical records of patients who were diagnosed with pure
UPSC between 2005 and 2020 in our institution. The association between
clinicopathological variables and CA-125 were analyzed. The accuracy of
the preoperative serum CA125 value in predicting metastasis sites was
evaluated by the receiving operating characteristic (ROC) curve analysis
and the most appropriate cut-off values available were selected.
Results: Seventy-eight patients met the study criteria. Median value of
preoperative serum CA-125 level was higher in patients with omental(p
<0.001), ovarian(p <0.001), cervical involvement (p
= 0.017) and deep myometrial invasion(≥50%) (p = 0.001). According to
the ROC curve, the optimal cut-off value of preoperative CA125 level for
predicting omental involvement was 35.5 U/mL (sensitivity: 93.8%,
specificity: 79.3%), cervical involvement was 15.0 U/mL (sensivity:
86.8%, specificity: 44.7%) and ovarian involvement was 32.5 U/mL
(sensivity: 77.3%, specificity: 72.2%). Conclusion: An elevated level
of preoperative serum CA-125 is a marker for omental, ovarian, cervical
involvement and deep myometrial invasion. There is a need for future
studies to evaluate the role of CA-125 in predicting recurrence and
survival in UPSC. Key Words: Cervical involvement, Cutoff value,
Preoperative CA-125, Uterine papillary serous carcinoma