M3 M21 SERUM LEVELS IN WOMEN WITH ADNEXAL MASSES AND INFLAMMATORY DISEASES/

The aim of the present study was to evaluate the clinical usefulness o f the cytokeratin tumor marker M3/M21 as a screening marker for ovaria n cancer, as a predictive marker in patients with adnexal masses and a s a prognostic factor in women with ovarian cancer. To determine the s pecificity of the M3/M21 test, we investigated M3/M21 serum levels in several benign conditions. This retrospective study comprises 37 patie nts with ovarian cancer FIGO stages la to III. Sera of patients with b enign cysts, endometriosis, pelvic inflammatory disease, inflammatory bowel disease and liver cirrhosis were evaluated in 90, 10, 38, 10 and 20 cases, respectively. With a sensitivity of 57% and a specificity o f 95%, M3/M21 is not suitable as a screening marker for ovarian cancer . Although M3/M21 is able to discriminate between ovarian cancer and b enign adnexal tumors (univariate logistic regression, p = 0.0003), M3/ M21 does not provide information additional to CA 125. M3/M21 serum le vels are elevated in several benign conditions such as liver cirrhosis and inflammatory bowel disease. In ovarian cancer patients, elevated M3/M21 serum levels prior to therapy were associated with poor overall and disease-free survival (log-rank test, p = 0.03; log-rank test, p = 0.01, respectively). M3/M21, while obviously not suitable for screen ing or differential diagnosis of adnexal masses, could be useful as an additional prognostic factor in ovarian cancer patients. (C) 1998 Wil ey-Liss, Inc.