Predictive value of serum Ca 15-3 levels in gynecologic neoplasms

Abstract

OBJECTIVE: To investigate the predictive value of CA 15-3 and CA 125 in the management of gynecologic malignancies MATERIALS AND METHODS: Serum levels of CA 15-3 and CA 125 were measured in 55 patients with a gynecologic neoplasm of which 35 were malignant (13 epithelial ovarian cancer, 11 cervix cancer, 10 endometrium cancer, and 1 vulvar cancer) and 20 were benign. Cut -off values for CA 15-3 was taken as 30U/mL. and 60U/mL. ; for CA 125 it was taken as 35U/mL. and 50U/mL . Sensitivity, specificity, positive and negative predictive values for each of the cut-off value are calculated. RESULTS: The mean values of CA 15-3 were 41.3 ± 8.4 and 20.2 ± 3.5 for malignant and benign tumors, respectively. Serum CA 15-3 and CA 125 values of malignant ovarian neoplasms were higher than those of the benign group, and the difference was statistically significant (P<0.01). Mean CA 15-3 levels in the malignant groups were 68.9±71.9 for ovarian cancer, 31.5+21.4 for endometrium cancer, and 19.6+9.6 for servix cancer. Mean CA 15-3 levels in the benign ovarian tumors and myoma uteri was 18.4±9.3 and 24.3+25.6, respectively. For the ovarian neoplasms, when CA 15-3 cut-off value was chosen as 30 U/ml, sensitivity was 69.3%, specificity was 85.7%, positive predictive value was 81.9% and negative predictive value was 75%. DISCUSSION: As a conclusion, CA 15-3 seems to be a useful marker for the non-mucinous epithelial ovarian neoplasms. In the ovarian neoplasms, the combined use of CA 15-3 with CA 125 may decrease the high false positivity of CA 125, but prospective compared studies with more patients are needed before a better conclusion can be made.