CASA and CA 125 in diagnosis and follow-up of advanced ovarian cancer

Background: CA 125 is the most important tumor marker in ovarian cancer. Du e to its low specificity and the fact that some ovarian malignancies do not produce considerable amounts of CA 125 a combination with the Cancer Assoc iated Serum Antigen (CASA) may reflect more accurately the clinical situati on. Materials and Methods: CA 125 and CASA determination was performed in s era of 78 patients with advanced ovarian cancer pre- and postoperatively, m onthly during chemotherapy and during follow-up care. The cut-off values fo r CASA were 4 U/ml, for CA 125 35 U/ml and 65 U/ml, respectively. Results: In the detection of advanced ovarian cancer a combination of both tumor mar kers was superior to the use of either CASA or CA 125 alone. In the follow- up situation CA 125 with the 35 U/ml cut-off showed the highest sensitivity . Both markers had similar prognostic relevance when marker levels three mo nths after surgery were used. Conclusion: CA 125 and CASA have similar char acteristics in preoperative diagnosis and postoperative follow-up. In clini cal situations with inconclusive or negative CA 125 serum values CASA is he lpful to improve management of patients with advanced ovarian cancer.