Skip to main content
SpringerLink
Log in

Diagnostic value of serum tumor markers evaluation for adnexal masses

  • Research Article
  • Published:
Central European Journal of Medicine

Abstract

Objective

The study aim was to investigate the diagnostic value of preoperative serum tumor markers in patients with adnexal masses.

Methods

Study included all (358) consecutive patients treated for adnexal tumors at the Clinic of Ob/Gyn, Clinical Center of Serbia in 12 months. Tumor marker levels (Ca 125, CEA, HE 4, Ca 19.9, and Ca 15.3), taken from all women on admission, were compared with postoperative histopathological findings of extracted tumors. Results. Women with malignant tumors had the highest levels of Ca 125, CEA, and HE 4 (p<0.01). Mucinous adenocarcinoma produced the highest amounts of Ca 19.9 and CEA. Ca 15.3 was the highest in women with endometrioid carcinoma. There were no significant differences in the levels of all examined tumor markers (p>0.05) between women with benign and borderline tumors. Ca 125, HE 4, and Ca 15.3 can discriminate the malignant from other tumor types well. The highest sensitivity, specificity, positive and negative predictive values (91.04%, 87.6%, 67.9%, 77.2%, respectively) were achieved for the combination of Ca 125 and HE 4.

Conclusions

Blood levels of examined tumor markers can be good predictors of the adnexal masses nature. For the most precise evaluation the combination of serum tumor markers should be used.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Rivas-Corchado LM, González-Geroniz M, Hernández-Herrera RJ. Epidemiological profile of ovarian cancer. Ginecol Obstet Mex 2011; 79:558–564

    PubMed  Google Scholar 

  2. Sehouli J, Henrich W, Braicu I, Lichtenegger W. Preoperative diagnostics in ovarian cancer. What do we really need? Gynäkologe 2006; 39:428–437

    Article  Google Scholar 

  3. Ameye L, Valentin L, Testa A.C, Van Holsbeke C, Domali E, Van Huffel S, et all. A scoring system to differentiate malignant from benign masses in specific ultrasound-based subgroups of adnexal tumors. Ultrasound Obstet Gynecol 2009; 33:92–101

    Article  CAS  PubMed  Google Scholar 

  4. American College of Obstetricians and Gynecologists. Committee Opinion No. 477. The role of the obstetrician-gynecologist in the early detection of epithelial ovarian cancer. Obstet Gynecol 2011; 117:742–746

    Article  Google Scholar 

  5. Menon U, Gentry-Maharaj A, Hallett R, Ryan A, Burnell M, Sharma A, et all. Sensitivity and specificity of multimodal and ultrasound screening for ovarian cancer, and stage distribution of detected cancers: results of the prevalence screen of the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS). Lancet Oncol 2009; 10:327–340

    Article  PubMed  Google Scholar 

  6. Joyner AB, Runowicz CD. Ovarian cancer screening and early detection. Womens Health 2009; 5:693–699

    Google Scholar 

  7. Donach M, Yu Y, Artioli G, Banna G, Feng W, Bast RC Jr, et all. Combined use of biomarkers for detection of ovarian cancer in high-risk women. Tumour Biol 2010; 31:209–215

    Article  CAS  PubMed  Google Scholar 

  8. Chan JK, Tian C, Monk BJ, Herzog T, Kapp DS, Bell J, et all. Prognostic factors for high-risk early-stage epithelial ovarian cancer: a Gynecologic Oncology Group study. Cancer 2008; 112:2202–2210

    Article  PubMed  Google Scholar 

  9. Terzic M, Dotlic J, Likic I, Ladjevic N, Brndusic N, Arsenovic N, Maricic S, Mihailovic T, Andrijasevic S. Current diagnostic approach to patients with adnexal masses: Which tools are relevant in routine praxis ? Chin J Cancer Res 2012 DOI: 10.3978/j.issn.1000-9604.2013.01.01

    Google Scholar 

  10. Edgell T, Martin-Roussety G, Barker G, Autelitano DJ, Allen D, Grant P, et al. Phase II biomarker trial of a multimarker diagnostic for ovarian cancer. J Cancer Res Clin Oncol 2010; 136:1079–1088

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  11. Visintin I, Feng Z, Longton G, Ward DC, Alvero AB, Lai Y, et all. Diagnostic markers for early detection of ovarian cancer. Clin Cancer Res 2008; 14:1065–1072

    Article  CAS  PubMed  Google Scholar 

  12. Chia YN, Marsden DE, Robertson G, Hacker NF. Triage of ovarian masses. Aust NZ J Obstet Gynaecol 2008; 48: 322–328

    Article  Google Scholar 

  13. Rong-Huan H, Wei-Miao Y, Li-Yan W, Yu-Yan M. Highly elevated serum CA-125 levels in patients with non-malignant gynecological diseases. Arch Gynecol Obstet 2011; 283:S107–S110

    Article  Google Scholar 

  14. Vorgias G, Iavazzo C, Savvopoulos P, Myriokefalitaki E, Katsoulis M, Kalinoglou N, et all. Can the preoperative Ca-125 level predict optimal cytoreduction in patients with advanced ovarian carcinoma? A single institution cohort study. Gynecol Oncol 2009; 112:11–15

    Article  PubMed  Google Scholar 

  15. Terzic M, Dotlic J, Likic Ladjevic I, Atanackovic J, Ladjevic N. Evaluation of the risk malignancy index diagnostic value in patients with adnexal masses. Vojnosanit Pregl 2011; 68:589–593

    Article  PubMed  Google Scholar 

  16. Dotlic J, Terzic M, Likic I, Atanackovic J, Ladjevic N. Evaluation of adnexal masses: correlation of clinical stage, ultrasound and hystopathological findings. Vojnosanit Pregl 2011; 68: 861–866

    Article  PubMed  Google Scholar 

  17. Van Calster B, Valentin L, Van Holsbeke C, Zhang J, Jurkovic D, Lissoni AA, et all. A novel approach to predict the likelihood of specific ovarian tumor pathology based on serum CA-125: a multicenter observational study. Cancer Epidemiol Biomarkers Prev 2011; 20:2420–2422

    Article  PubMed  Google Scholar 

  18. Langmar Z, Nemeth M, Vlesko G, Kiraly M, Hornyak L, Bosze P. HE4-a novel promising serum marker in the diagnosis of ovarian carcinoma. Eur J Gynaecol Oncol 2011; 32:605–610

    CAS  PubMed  Google Scholar 

  19. Granato T, Midulla C, Longo F, Colaprisca B, Frati L, Anastasi E. Role of HE4, CA72.4, and CA125 in monitoring ovarian cancer. Tumour Biol. 2012 DOI: 10.1007/s13277-012-0381-8

    Google Scholar 

  20. Anastasi E, Marchei GG, Viggiani V, Gennarini G, Frati L, Reale MG. HE4: a new potential early biomarker for the recurrence of ovarian cancer. Tumour Biol 2010; 31:113–119

    Article  CAS  PubMed  Google Scholar 

  21. Zheng H, Gao Y. Serum HE4 as a Useful Biomarker in Discriminating Ovarian Cancer From Benign Pelvic Disease. Int J Gynecol Cancer. 2012 DOI: 10.1097/IGC.0b013e318249bee7

    Google Scholar 

  22. Ayhan A, Guven S, Guven ES, Kucukali T. Is there a correlation between tumor marker panel and tumor size and histopathology in well staged patients with borderline ovarian tumors? Acta Obstet Gynecol Scand. 2007; 86:484–90

    Article  CAS  PubMed  Google Scholar 

  23. Ugur MG, Ozturk E, Balat O, Dikensoy E, Teke S, Aydin A. Do high levels of CA 19-9 in women with mature cystic teratomas of the ovary warrant further evaluation? Eur J Gynaecol Oncol. 2012; 33:207–10

    CAS  PubMed  Google Scholar 

  24. van Haaften-Day C, Shen Y, Xu F, Yu Y, Berchuck A, Havrilesky LJ, et al. OVX1, macrophage-colony stimulating factor, and CA-125-II as tumor markers for epithelial ovarian carcinoma: a critical appraisal. Cancer 2001; 92:2837–2844

    Article  PubMed  Google Scholar 

  25. Mabrouk M, Elmakky A, Caramelli E, Farina A, Mignemi G, Venturoli S, et al. Performance of peripheral (serum and molecular) blood markers for diagnosis of endometriosis. Arch Gynecol Obstet. 2011 DOI: 10.1007/s00404-011-2122-2124

    Google Scholar 

  26. Sørensen SS, Mosgaard BJ. Combination of cancer antigen 125 and carcinoembryonic antigen can improve ovarian cancer diagnosis. Dan Med Bull. 2011; 58:A4331

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Clinic of Obstetrics and Gynecology, Clinical Center of Serbia, Dr Koste Todorovica 26, 11000, Belgrade, Serbia

    Milan Terzic, Jelena Dotlic, Ivana Likic, Natasa Brndusic, Igor Pilic & Jovan Bila

  2. School of Medicine, University of Belgrade, Dr Subotica 8, 11000, Belgrade, Serbia

    Milan Terzic, Ivana Likic, Branka Nikolic & Jovan Bila

  3. Clinic of Obstetrics and Gynecology „Narodni Front“, Kraljice Marije 62, 11000, Belgrade, Serbia

    Branka Nikolic

  4. Occupational Health Department, General Health Center “Savski Venac”, Pasterova 1, 11000, Belgrade, Serbia

    Sanja Maricic

  5. Department of Cellular Pathology, PathLinks Pathology Services, Lincoln County Hospital, Greetwell Road, Lincoln, LN2 5QY, UK

    Nebojsa Arsenovic

Authors
  1. Milan Terzic
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jelena Dotlic
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ivana Likic
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Branka Nikolic
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Natasa Brndusic
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Igor Pilic
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Jovan Bila
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Sanja Maricic
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Nebojsa Arsenovic
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Milan Terzic.

About this article

Cite this article

Terzic, M., Dotlic, J., Likic, I. et al. Diagnostic value of serum tumor markers evaluation for adnexal masses. cent.eur.j.med 9, 210–216 (2014). https://doi.org/10.2478/s11536-013-0218-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2478/s11536-013-0218-x

Keywords

Search

Navigation