CLINICAL-SIGNIFICANCE OF THE TUMOR-MARKERS CA-125-II AND CA-72-4 IN OVARIAN-CARCINOMA

In a retrospective study we compared the usefulness of the tumour mark er CA 72-4 with the established marker CA 125 II (both EIA on Cobas-Co re, Hoffmann LaRoche, Basel Switzerland) at the time of primary diagno sis of ovarian carcinoma (n = 123) in order to discriminate between ov arian carcinomas of different histological type. We compared their dia gnostic value, behaviour in follow-up care and evaluated possible comb inations. Fixing specificity at 95% vs. benign gynaecological diseases (n = 37) as the clinically relevant reference group, we found cut-off values of 160 U/mL for CA 125 II and 3.0 U/mL for CA 72-4. On the bas is of this specificity, we found comparable sensitivity for CA 125 II and CA 72-4 for all kinds of ovarian carcinoma at the time of primary diagnosis. With regard to histology, we found best sensitivity for CA 125 II in serous ovarian cancer and for CA 72-4 in mucinous ovarian ca ncer. Additional sensitivities were found in ovarian carcinoma in gene ral but little in serous ones. No additive sensitivity was found in mu cinous ovarian carcinomas with CA 72-4 as leading marker. In follow-up care, CA 72-4 was the leading marker in 11 cases and CA 125 II in 16, while in one case both markers were negative. In 6 cases the change o f values reflecting clinical follow-up-care was within the so-called r eference range. According to our results, at the time of primary diagn osis because of lack of histological findings the combined determinati on of CA 125 II and CA 72-4 can be recommended. In follow-up care and control of efficacy of therapy the preoperative positive or leading ma rker is generally sufficient. The determination of both markers in fol low-up care is indicated only if they both are negative at primary dia gnosis and until one of them becomes clearly positive. (C) 1996 Wiley- Liss, Inc.