COMBINED USE OF CA-125 AND CA-15-3 IN PATIENTS WITH ENDOMETRIAL CARCINOMA

Serum levels of CA 125 and CA 15-3 were measured in 148 patients with primary endometrial carcinoma. CA 125-positive levels were found in 33 and 22% of the cases using a cutoff of 35 and 65 U/ml, respectively. Thirty-five (24%) and 12 (8%) patients had CA 15-3 levels higher than 30 and 50 U/ml, respectively. Among 144 patients with clinical stage I -II, 17 (12%) had extrauterine disease. CA 125 (>65 U/ml) and CA 15-3 titers (>30 U/ml) were found in 59 and 47% of occult stage III with re spect to 16 and 18% in stage I-II of disease, respectively (P = 0.0001 and P = 0.01). The combined use of CA 125 and CA 15-3 resulted in a r eduction of false-positive results of CA 125 with an acceptable sensit ivity of 41%. Low-risk patients (G1 and M0-M1 tumors) showed a CA 125 positivity (>35 U/ml) of 10% with respect to 37% of high-risk patients (G2-G3 and M2 tumors) (P = 0.0026). CA 125 positivity (>65 U/ml) was 22% in patients without metastatic lymph node involvement, compared to 58% of cases with histologically positive lymph nodes (P = 0.022). A similar trend, although not statistically significant, was found for C A 15-3. A good correlation was found between CA 125 and CA 15-3 serum levels and clinical course of disease during chemotherapy. A statistic ally significant relationship was demonstrated between CA 125 (>65 U/m l) (P 0.0027) and CA 15-3 positivity (CA 15-3 >30 and 50 U/ml) (P = 0. 0004 and P = 0.00025) and a shorter survival. Our data show that CA 12 5 and CA 15-3 may be used as predictors of extrauterine spread and in monitoring of chemotherapy response in endometrial cancer. Moreover, t he presence of elevated levels of these antigens may identify a subset of patients with a particularly poor prognosis. (C) 1994 Academic Pre ss, Inc.