TISSUE POLYPEPTIDE SPECIFIC ANTIGEN AND CANCER-ASSOCIATED SERUM ANTIGEN IN THE FOLLOW-UP OF OVARIAN-CANCER

420 clinical and serological examinations prior to surgery and during follow-up were performed in 30 patients suffering from ovarian cancer. The population consisted of three FIGO stage Ia, nine stage Ic, four stage II and fourteen stage III cases. Serous carcinoma of the ovary, mucinous carcinoma and other kinds of oval inn cancer were found in 16 , 9 and 5 cases, respectively. The serum levels of the tumor markers t issue polypeptide specific antigen (TPS), cancer associated serum anti gen (CASA) and carbohydrate antigen 125 (CA 125) were determined. Cut- off values of 97 U/l, 4 U/ml and 35m U/ml for TPS, CASA and CA 125, re spectively, were selected according to the 95% of serum concentrations measured in healthy controls. Sen sitivity, specificity, PPV and NPV of CA 125 were 75%/96%/69%/92%, respectively. Sensitivity,, specificit y, PPV and NPV of TPS were 67%/54%/59%/90%, respectively. CASA showed a sensitivity of 58%, specificity of 96% and a PPV and NPV of 73%/94%, respectively. The combination of TPS and CA125 increased the sensitiv ity to 81%, reaching a specificity of 82% and a PPV and NPV of 58/96%, respectively. The combination of CASA and CA125 showed a sensitivity, specificity, PPV and NPV of 55/85/65/96%, respectively. Twelve patien ts developed recurrence of disease after response to primary treatment . TPS, CASA and CA 125 detected recurrent disease in six, two and four cases, respectively. For TPS mean lead time was 4.6 months (range 2-1 8 months), for CASA 1.7 months (range 1-6 months), and for CA 125 3.5 months (range 1-24 months. As a matter of fact TPS never showed lead t ime effects in patients without elevated pretherapeutic levels. A comb ination of all makers showed a mean lead time of 6.72 months. Detectio n of recurrent disease by CA 125 is improved when CA 125 is used in co mbination with TPS, especially in those patients with pretherapeutical ly elevated TPS serum levels.