Preoperative serum CA125: a useful marker for surgical management of endometrial cancer
Identifieur interne : 001976 ( Main/Merge ); précédent : 001975; suivant : 001977Preoperative serum CA125: a useful marker for surgical management of endometrial cancer
Auteurs : Tao Jiang ; Ling Huang ; Shulan ZhangSource :
- BMC Cancer [ 1471-2407 ] ; 2015.
Abstract
Surgery plays an important role in the management of endometrial cancer at all stages, particularly early clinical stage. There are still many unanswered questions regarding optimal surgical management of endometrial cancer, particularly regarding which patients should undergo lymphadenectomy. The aim of this study was to evaluate the role of preoperative cancer antigen 125 (CA125) serum levels for surgical management in endometrial cancer patients.
A total of 995 patients with endometrial cancer, according to inclusion criteria of a preoperative serum level of CA125, were selected. The association between clinicopathological factors and CA125 were analyzed. Receiver operating characteristic (ROC) curve was used to evaluate the role of preoperative serum CA125 in predicting lymph node metastasis, adnexal involement, cervical stromal invasion in all patients, especially patients with clinical stage I. Survival analyses were also performed according to the four groups of preoperative CA125 serum levels.
Elevated CA125 level was significantly associated with all clinicopathological parameters, including age and menopause, but not histology type. ROC curve analysis results showed the CA125 serum level of 25 U/mL was the best cutoff to predict the lymph node metastasis. It was with 78% of sensitivity, 78% of specificity, 77.6% of false positive rate, 2.3% of false negative rate in all patients. In patients with clinical stage I, it was with 71.7% of sensitivity, 77.6% of specificity, 83.3% of false positive rate, 2.2% of false negative rate. The best cutoff to evaluate adnexal involement in patients with clinical stage I was 30U/ml, with 81% sensitivity, and 78.4% specificity. Survival analysis revealed CA125, FIGO stage, histology grade, and positive peritoneal cytology as independent prognostic factors of endometrial cancer.
Preoperative serum CA125 is an important predictor for patients with endometrial cancer and it should be taken into consideration when surgical management is determined, especially if a lymphadenectomy should be undertaken in patients with clinical stage I.
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DOI: 10.1186/s12885-015-1260-7
PubMed: 25964114
PubMed Central: 4438478
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Preoperative serum CA125: a useful marker for surgical management of endometrial cancer</title><author><name sortKey="Jiang, Tao" sort="Jiang, Tao" uniqKey="Jiang T" first="Tao" last="Jiang">Tao Jiang</name><affiliation><nlm:aff id="Aff1">Department of Gynecology and Obstetrics, Shengjing Hospital of China Medical University, No.36, Sanhao Street, Heping District, Shenyang, Liaoning Province 110004 China</nlm:aff><wicri:noCountry code="subfield">Liaoning Province 110004 China</wicri:noCountry></affiliation></author><author><name sortKey="Huang, Ling" sort="Huang, Ling" uniqKey="Huang L" first="Ling" last="Huang">Ling Huang</name><affiliation><nlm:aff id="Aff1">Department of Gynecology and Obstetrics, Shengjing Hospital of China Medical University, No.36, Sanhao Street, Heping District, Shenyang, Liaoning Province 110004 China</nlm:aff><wicri:noCountry code="subfield">Liaoning Province 110004 China</wicri:noCountry></affiliation></author><author><name sortKey="Zhang, Shulan" sort="Zhang, Shulan" uniqKey="Zhang S" first="Shulan" last="Zhang">Shulan Zhang</name><affiliation><nlm:aff id="Aff1">Department of Gynecology and Obstetrics, Shengjing Hospital of China Medical University, No.36, Sanhao Street, Heping District, Shenyang, Liaoning Province 110004 China</nlm:aff><wicri:noCountry code="subfield">Liaoning Province 110004 China</wicri:noCountry></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">25964114</idno><idno type="pmc">4438478</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4438478</idno><idno type="RBID">PMC:4438478</idno><idno type="doi">10.1186/s12885-015-1260-7</idno><date when="2015">2015</date><idno type="wicri:Area/Pmc/Corpus">000C23</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000C23</idno><idno type="wicri:Area/Pmc/Curation">000C22</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000C22</idno><idno type="wicri:Area/Pmc/Checkpoint">000F67</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000F67</idno><idno type="wicri:Area/Ncbi/Merge">007365</idno><idno type="wicri:Area/Ncbi/Curation">007365</idno><idno type="wicri:Area/Ncbi/Checkpoint">007365</idno><idno type="wicri:Area/Main/Merge">001976</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Preoperative serum CA125: a useful marker for surgical management of endometrial cancer</title><author><name sortKey="Jiang, Tao" sort="Jiang, Tao" uniqKey="Jiang T" first="Tao" last="Jiang">Tao Jiang</name><affiliation><nlm:aff id="Aff1">Department of Gynecology and Obstetrics, Shengjing Hospital of China Medical University, No.36, Sanhao Street, Heping District, Shenyang, Liaoning Province 110004 China</nlm:aff><wicri:noCountry code="subfield">Liaoning Province 110004 China</wicri:noCountry></affiliation></author><author><name sortKey="Huang, Ling" sort="Huang, Ling" uniqKey="Huang L" first="Ling" last="Huang">Ling Huang</name><affiliation><nlm:aff id="Aff1">Department of Gynecology and Obstetrics, Shengjing Hospital of China Medical University, No.36, Sanhao Street, Heping District, Shenyang, Liaoning Province 110004 China</nlm:aff><wicri:noCountry code="subfield">Liaoning Province 110004 China</wicri:noCountry></affiliation></author><author><name sortKey="Zhang, Shulan" sort="Zhang, Shulan" uniqKey="Zhang S" first="Shulan" last="Zhang">Shulan Zhang</name><affiliation><nlm:aff id="Aff1">Department of Gynecology and Obstetrics, Shengjing Hospital of China Medical University, No.36, Sanhao Street, Heping District, Shenyang, Liaoning Province 110004 China</nlm:aff><wicri:noCountry code="subfield">Liaoning Province 110004 China</wicri:noCountry></affiliation></author></analytic><series><title level="j">BMC Cancer</title><idno type="eISSN">1471-2407</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Surgery plays an important role in the management of endometrial cancer at all stages, particularly early clinical stage. There are still many unanswered questions regarding optimal surgical management of endometrial cancer, particularly regarding which patients should undergo lymphadenectomy. The aim of this study was to evaluate the role of preoperative cancer antigen 125 (CA125) serum levels for surgical management in endometrial cancer patients.</p></sec><sec><title>Methods</title><p>A total of 995 patients with endometrial cancer, according to inclusion criteria of a preoperative serum level of CA125, were selected. The association between clinicopathological factors and CA125 were analyzed. Receiver operating characteristic (ROC) curve was used to evaluate the role of preoperative serum CA125 in predicting lymph node metastasis, adnexal involement, cervical stromal invasion in all patients, especially patients with clinical stage I. Survival analyses were also performed according to the four groups of preoperative CA125 serum levels.</p></sec><sec><title>Results</title><p>Elevated CA125 level was significantly associated with all clinicopathological parameters, including age and menopause, but not histology type. ROC curve analysis results showed the CA125 serum level of 25 U/mL was the best cutoff to predict the lymph node metastasis. It was with 78% of sensitivity, 78% of specificity, 77.6% of false positive rate, 2.3% of false negative rate in all patients. In patients with clinical stage I, it was with 71.7% of sensitivity, 77.6% of specificity, 83.3% of false positive rate, 2.2% of false negative rate. The best cutoff to evaluate adnexal involement in patients with clinical stage I was 30U/ml, with 81% sensitivity, and 78.4% specificity. Survival analysis revealed CA125, FIGO stage, histology grade, and positive peritoneal cytology as independent prognostic factors of endometrial cancer.</p></sec><sec><title>Conclusion</title><p>Preoperative serum CA125 is an important predictor for patients with endometrial cancer and it should be taken into consideration when surgical management is determined, especially if a lymphadenectomy should be undertaken in patients with clinical stage I.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Amant, F" uniqKey="Amant F">F Amant</name></author><author><name sortKey="Moerman, P" uniqKey="Moerman P">P Moerman</name></author><author><name sortKey="Neven, P" uniqKey="Neven P">P Neven</name></author><author><name sortKey="Timmerman, D" uniqKey="Timmerman D">D Timmerman</name></author><author><name sortKey="Van Limbergen, E" uniqKey="Van Limbergen E">E Van Limbergen</name></author><author><name sortKey="Vergote, I" 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